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Social Phobia Treatment

Social phobia is a fear of social situations or public performance in which a person may be embarrassed by symptoms of anxiety or a panic attack.

About 80 percent of people who suffer from social phobia find relief from their symptoms when treated with cognitive-behavioral therapy (specific form of short-term psychotherapy) or medications or a combination of the two.

Medications include antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs), as well as drugs known as high-potency benzodiazepenes.

Some people with a form of social phobia called performance phobia have been helped by beta-blockers, which are more commonly used to control high blood pressure.

Therapy may involve learning to view social events differently; being exposed to a seemingly threatening social situation in such a way that it becomes easier to face; and learning anxiety reducing techniques, social skills, and relaxation techniques.

Psychological Treatment of Social Phobia

Cognitive-behavior therapy is also very useful in treating social phobia. The central component of this treatment is exposure therapy, which involves helping patients gradually become more comfortable with situations that frighten them. The exposure process often involves three stages. The first involves introducing people to the feared situation. The second level is to increase the risk for disapproval in that situation so people build confidence that they can handle rejection or criticism. The third stage involves teaching people techniques to cope with disapproval. In this stage, people imagine their worst fear and are encouraged to develop constructive responses to their fear and perceived disapproval.

Cognitive-behavior therapy for social phobia also includes anxiety management training-for example, teaching people techniques such as deep breathing to control their levels of anxiety. Another important aspect of treatment is called cognitive restructuring, which involves helping individuals identify their misjudgments and develop more realistic expectations of the likelihood of danger in social situations.

Dynamic psychotherapy may help some patients, particularly those whose social phobia is associated with preexisting problems in personal relationships. However there have been no controlled trials of this form of treatment.

Supportive therapy such as group therapy, or couples or family therapy to educate significant others about the disorder, is also helpful. Sometimes people with social phobia also benefit from social skills training.

Drug treatment for Social Phobia

  • Benzodiazepines - The main use of Benzodiazepines is to help patients cope with social encounters until another treatment has led to improvement.
  • Beta-adrenergic blockers - Beta-adrenergic blockers such as atenolol help to control tremor and palpitations, which are often the most distressing symptoms specially in the specific forms of social phobia.
  • Monoamine oxidase inhibitors (MAOI) - Phenelzine has been shown to be more effective in the treatment of social phobia than placebo and atenolol. Moclobemide is also effective in social phobia.
  • Specific Serotonin re-uptake inhibitors (SSRI) - Fluvoxamine, paroxetine and sertraline have been shown in controlled trials to be effective for social phobia and open studies suggest that fluoxetine may be effective also.

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