Social Skills Training Encourages a Patient with Social Anxiety Disorder to Undertake Challenging Behavioral Experiments.
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Date
2014-01-21
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Abstract
Introductions: Cognitive models of social anxiety disorder (SAD), such as that
developed by Clark & Wells, conceptualize the attention to, and misinterpretation of,
internal information as a key maintaining factor. Social skills training (SST), a frequently
used cognitive therapy (CT) technique for various mental disorders, is often justified
according to a skills-deficit model of SAD, which assumes that anxiety arises from
inadequate social interaction skills. However, the evidence largely suggests little to no
skills deficit in this patient group, indicating that SST is not necessarily a technique to be
used in CT for most SAD patients. In this study, we present a patient with SAD who
negatively perceived her social skills abilities, and who benefitted from SST. We also
discuss the role of brief SST in CT treatment.
Presentation of Case: The patient was a Japanese female with excessive fear of social
interactions who negatively perceived her own social skills. Cognitive therapy mainly
consisted of case formulation, behavioral experiments, and opinion surveying based on
the Clark & Wells model. As the patient felt too anxious to attempt behavioral
experiments, due to her negative perception of her own social skills, SST was briefly
employed in the course of CT.
Discussion and Conclusion: As the patient’s actual social skills abilities were neverformally assessed, it is impossible to know if she had any social skills deficits prior to
treatment, and, if so, if they were improved by the SST provided. However, SST
encouraged the patient to try challenging tasks, notably behavioral experiments and
homework centering on feared social situations. Although SST should not necessarily be
included in CT for SAD patients, SST can help patients to decrease their excessive fear
of being negatively perceived due to poor social skills, making it easier for them to try
challenging behavioral experiments in feared social situations.
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Keywords
Social anxiety disorder, social phobia, cognitive therapy, social skills training, case study
Citation
Yoshinaga Naoki, Shimizu Eiji. Social Skills Training Encourages a Patient with Social Anxiety Disorder to Undertake Challenging Behavioral Experiments. British Journal of Medicine and Medical Research. 2014 Jan; 4(3): 905-913.