Treatment for Social Phobia & Social Anxiety
The two most common types of treatment for social anxiety are cognitive behavioral therapy (CBT) and exposure therapy (ET). Cognitive therapy teaches a person to adopt more constructive beliefs and attitudes towards social interaction. For example, a therapist might help a child understand that others aren't judging them as harshly as they judge themselves. They might work on issues related to social and emotional intelligence or talk through feelings of insecurity and vulnerability. Therapists will also focus on teaching a child methods to manage their anxiety.
Exposure therapy, meanwhile, puts children in social situations that they would normally avoid. Therapists will gradually expose kids to more anxiety-provoking situations until they can manage the same tasks that other children their age engage in. Ideally, positive feedback is provided after each session in an attempt to alter the self-talk and reflective harsh judgments that kids with social anxiety typically engage in.
Which type of therapy is most effective for treating social anxiety?
A meta-analysis (review of multiple studies) conducted by Feske and Chambless (1995) found CBT and ET to be equally effective in treating social phobia, though they noted that more exposure therapy sessions were associated with a greater reduction in symptoms. However, it's not recommended that exposure therapy be used alone, since people with social phobia tend to scrutinize themselves in a negative way after social interactions. If CBT is not used to help clients identify and dispute their irrational thoughts, exposure therapy alone can serve to reinforce negative beliefs.
Other types of therapy for social phobia
Group therapy sessions are often used for kids with social anxiety. Not only does this pair them together with others who can offer empathy and support, but it provides a built-in focus group where they can practice interacting with others and test out newly acquired social skills in an environment where constructive feedback is offered. Such groups are typically headed by a cognitive therapist who specializes in social anxiety, and may include a workbook or other curriculum materials as part of the course. These sessions are generally a little cheaper than traditional therapy, so they're a good option for parents.
Specialized types of cognitive therapy (such as cognitive bias modification) are sometimes used, as are sessions of parent-child interaction therapy. But these are typically secondary treatments used in combination with exposure therapy and CBT.
Some young people may experience significant improvements in their social anxiety from a relatively brief intervention of 8 to 12 sessions. Other kids may require ongoing support. (Spence, 2003) There are also some online options available. One study published in the October 2010 issue of the Australian and New Zealand Journal of Psychiatry found that self-guided, Internet-based CBT reduced social phobia symptoms in most of the participants. The program consisted of 8 online sessions with components similar to that of face-to-face cognitive behavioral therapy. (Rodriguez, 2011)