Treatment of social phobia from a cognitive perspective: A case study

Social phobia is one of the most disabling and poorly diagnosed anxiety disorders, presenting an annual prevalence of 1.2% in the European Union, somewhat higher in women than men. In the past decade, there has been a significant progress in cognitive models oriented towards the study and treatment of anxiety disorders. These new models focus on how, more than what, individuals with emotional disorders think. Models have evolved from "fear of negative evaluation", as the central component of cognitive formulations in the aetiology and maintenance of this disorder, to a more purely cognitive processing that underlines: (a) increased self-focused attention linked to a decrease in the observation of others and their responses-attentional bias-; (b) frequent excessively negative inferences about how one appears to others are made-interpretative bias-; (c) extensive use of overt and covert safety behaviours, and (d) problematic pre- and post-social event processing (Clark & Wells, 1995; Wells, 1997, 2000). New empirical contributions indicate the superiority of cognitive therapy based on these cognitive processing models over exposure (Clark et al., 2006). We present a clinical case report of a 28-year-old man undergoing a cognitive-behavioural intervention essentially based on cognitive models and techniques (Eysenck, 1997; Clark & Wells, 1995). Comparison of pre and post-treatment results and generalization of objectives show therapeutic efficacy.