Behavioral Therapy Most Effective for Social Phobia
> 12/17/2007 12:53:03 PM

Social Anxiety Disorder (SAD) or Social Phobia, an irrational and disabling fear of interaction with unfamiliar people, public embarrassment and judgement in the eyes of others is the most common and most commonly perplexing anxiety disorder, affecting approximately 1 in 8 people. SAD usually begins in late childhood or early adolescence, and it may prevent its victims from venturing into the public sphere, making professional contacts or establishing personal relationships. An affected patient's overwhelming desire to avoid these perceived threats often leaves them isolated and susceptible to the adverse influence of additional mental health conditions. Nearly all patients who suffer from SAD realize that their fears are exaggerated or misplaced, but this knowledge does little to free them from their disorder.

How, then, can healthcare professionals counter this potentially disabling condition? While SSRI antidepressants like fluoxetine (Prozac) have long been known to produce desirable results in children and adolescents with Social Anxiety Disorder, providing a moderate sense of relief and curbing the fatalistic tendencies so common to SAD, a recent study found organized behavioral therapy to be just as effective, if not more so. Researchers at the University of Central Florida assigned 139 children between the ages of 7 and 17 to one of three treatments: fluoxetine, behavioral therapy and sugar-pill placebo. After the 12-week clinical program, researchers returned to the sample population over a 5 year follow-up period to assess the treatment plans' respective levels of efficiency. Tracking patient responses via self-evaluation, parental reports and clinical evaluations, researchers found that an astounding 79% of the behavioral therapy group responded positively to treatment; 36% of the SSRI group also reported noticeable improvements, compared to only 6% of the placebo group. The study's most encouraging statistic: at program's end after 2 1/2 months of treatment, 53 percent of the behavioral therapy group no longer qualified for SAD diagnoses. At the 5 year assessment point, researchers found that gains first noted at the 12-week mark remained in place and that, incredibly, "the general functioning of SET-C treatment responders was not significantly different from those who never had a disorder."

Social Effectiveness Therapy For Children, an extended treatment program combining social skills training, cooperative peer-group activities and exposure therapy, aims to teach kids by example and direct experience that interacting with others and participating in various activities together need not be a frightening experience. The love and friendship of others is an absolutely crucial element of a satisfied life, and this study implies that teaching an anxious patient how to cultivate and enjoy these experiences with minimal stress lies at the heart of successful SAD treatment plans.

Our conclusion? Though Social Phobia often presents with symptoms similar to other mental illnesses, and patients can experience some of the altered brain chemistries related to depression and its variations, correcting behavioral habits seems to be a deeper and more comprehensive response to social phobias. Patients cannot expect to completely free themselves from their fears until they've identified problem behaviors and begun the often painful process of reforming them. But we can't further the perception that something is "wrong" with these patients, as such a sentiment would only confirm their fatalistic impulses. We should simply let them know that it's OK for them to experience a little more difficulty than most when developing the social skills that will guide them through life. If those developmental needs go undernourished or ignored by others, patients may face years of unnecessary pain and loneliness, and if a 12-week program can do so much good it should be offered to every affected individual.

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