Self-Efficacy Is a Key Component of CBT for Anxiety

Social anxiety disorder (SAD) can significantly impair the quality of an individual’s life. People who experience symptoms of SAD can find it difficult to be in social settings and often have trouble speaking in front of groups of people or feeling at ease when in crowds. Feelings of inadequacy and fear can overwhelm people who have severe symptoms. The prevalence of SAD, which is thought to be over 12% of the general population, has motivated mental health experts to create effective strategies to treat SAD. The most widely accepted approach is individual cognitive behavioral therapy (I-CBT). Cognitive restructuring is one aspect of I-CBT and focuses on changing the cognitive reappraisals (CR) an individual experiences. The goal of CR is to provide a person with SAD an alternative emotional reaction in distressing situations. CR that improves self-efficacy (CR-SE) is one type of cognitive therapy that empowers individuals so that they can self-regulate their moods and anxiety when needed.

Research suggests that I-CBT is highly effective for people with SAD. But less is known about the effect of CR-SE on I-CBT. Therefore, Philippe R. Goldin of the Department of Psychology at Stanford University compared the outcomes of 38 clients with SAD who participated in I-CBT to those of 37 individuals with SAD who were waitlisted (WL). He found that after 16 sessions, the I-CBT participants saw significant reductions in anxiety compared to the WL participants. The improvements were maintained when Goldin assessed the participants 1 year later. Additionally, the I-CBT participants had increases in CR-SE that directly impacted their reduction in anxiety at follow-up. Specifically, the individuals who had gains in CR-SE saw reductions in anxious symptoms that were approximately twice the level of those with no improvement in CR-SE. Goldin believes these results clearly identify one aspect of anxiety that should be targeted in future treatment efforts. He added, “Increasing CR-SE may be an important mechanism by which I-CBT for SAD produces both immediate and long-term reductions in social anxiety.”

Goldin, P. R., Ziv, M., Jazaieri, H., Werner, K., Kraemer, H., Heimberg, R. G., et al. (2012). Cognitive reappraisal self-efficacy mediates the effects of individual cognitive-behavioral therapy for social anxiety disorder. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0028555

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  • kathleen


    June 21st, 2012 at 4:17 AM

    For those with social anxiety there is no question that they are on the lookout for the most effective treatments which are available to help them with their social issues. It is hard to imagine just how difficult it could be to naviagte your daily life when it can be so hindered by something like social anxiety disorder.

  • Marla s

    Marla s

    June 21st, 2012 at 11:06 AM

    Having the ability to self regulate and look for other better things when something bad is happening to us in our lives is something that could beenfit anyone and not just those who suffer from social anxiety disorder. If we give the mind a more positive way to approach our problems and find ways that we do not get so overwhelmed by those problems, then that is going to make life so much easier for us at so many levels. Yes I know that this particular study was aimed at helping those with social anxiety disorder develop the means to deal with those powerful situations that will often bring them down, but don’t discount the power of this kind of training no matter what challenges you could be facing in your own life. This is something that all of us can take and learn from.

  • Peter Strong

    Peter Strong

    June 21st, 2012 at 12:46 PM

    Cognitive therapy is a good approach because it focuses on the habitual and reactive thought patterns and blindly held beliefs that fuel the anxiety reaction. We need to not only change this negative self-talk, but we also need to change our relationship to thoughts and beliefs in general. In Mindfulness Therapy we focus on changing what we call the “Identification habit” – the tendency to become blindly identified with thoughts. This is the root of the whole problem.

  • Maple Tree

    Maple Tree

    June 22nd, 2012 at 12:21 AM

    CBT has been so much in the spotlight of late!Always good to have reassurances of popular treatment techniques :)

  • Renee


    June 23rd, 2012 at 4:22 AM

    As someone who knows the pain of social anxiety I have always been hesitant to try CBT mainly because I have a hard time believing that anyone could give me a new way to process that anxiety and give me feelings about it that were neutral instead of frightening. That alone is kind of frightening to me!

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