Social Anxiety: Making a difference with exposure and Acceptance and Commitment Therapy

Social Anxiety: Making a difference with exposure and Acceptance and Commitment Therapy

According to the National Institute of Mental Health, 12.1% of adults experience social anxiety disorder (SAD) at some time in their lives. Social anxiety disorder is characterized by a high degree of fear related to social situations which usually leads to avoidance of situations involving other people (National Institute of Mental Health). Several treatments have been evaluated for SAD including Cognitive Behavior Therapy (CBT) and Acceptance and Commitment Therapy (ACT). Cognitive behavior therapy emphasizes changing beliefs about negative thoughts as well as exposing the person to unpleasant thoughts and situations, and although CBT is effective for the majority of patients, about 25% do not respond to treatment (Dalrymple & Herbert, 2007). Acceptance and Commitment Therapy is different from CBT in that it encourages acceptance of negative thoughts instead of focusing on changing the thoughts. In addition, ACT promotes the use of mindfulness, which aids the patient in fully experiencing the present moment without judgment. The results of ACT have been positive for a number of conditions including depression, substance abuse, chronic pain, and psychosis; however, less research has been conducted evaluating ACT for social anxiety (Dalrymple & Herbert, 2007). Therefore, a recent study by Dalrymple and Herbert (2007) examined a treatment package that included exposures combined with various components of ACT to treat SAD. In this study, the authors recruited 19 adults with social anxiety disorder and provided individual treatment for 1 hour per week. Initial sessions focused on aiding participants in recognizing that attempts to control the past have no value. Later sessions focused on accepting undesirable thoughts and acting according to personal goals while being exposed to challenging social situations which caused some anxiety. Mindfulness was also incorporated to help participants become aware of undesirable thoughts without making judgments about their thoughts or trying to control their thoughts in any way or make them go away. Throughout treatment, participants also completed homework outside of scheduled treatment time. At the end of the study, 17 participants had completed treatment and on average, their levels of fear decreased by approximately 30% and levels of avoidance decreased by approximately 60%. In addition, 93% of the participants were highly satisfied with the treatment.

Dalrymple, K. L., & Herbert, J. D. (2007). Acceptance and commitment therapy for Generalized Social Anxiety Disorder. Behavior Modification, 31, 543-68.

National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/statistics/social-anxiety-disorder.shtml