Treatment of social phobias

Social phobia, despite a prevalence in the general population of 1.5% denoting a common disorder, has been relatively neglected from the viewpoints of psychopathology and of treatment. Two subtypes of social phobia have been differentiated: specific (characterized by anxiety in one situation, e.g., public speaking) and generalized (characterized by anxiety in several social situations). The syndrome is frequently complicated by alcohol abuse or dependence. Among the treatment targets are symptoms of anxiety, avoidance behavior, negative cognitions concerning the reactions of others, and, less frequently, social skills deficits. Both pharmacologic and cognitive-behavioral treatments have been found effective in this disorder, and it seems likely that the two treatments will complement each other. The treatment literature is reviewed, and recommendations concerning a state-of-the-art treatment approach to both specific and generalized social phobia are made. Potential complications and limitations are discussed.