At some point in our lives, we all experience symptoms of anxiety. Public speaking or other unfamiliar situations can provoke natural feelings of anxiety. When these natural feelings turn into excessive anxiety and worry, they might be classified as an anxiety disorder.

In DSM-5, social anxiety disorder, also known as social phobia, is defined as a pronounced and persistent fear of scrutiny in social or performance situations, and it may account for up to 70% of all clients (Beidel et al., 2014).

SAD has its onset in adolescence and affects about 2% of the general population (Turner et al., 1994). SAD influences social, occupational and academic aspects of people’s lives.

Luckily, we can help people with SAD. A new study, a randomized controlled trial, by Deborah Beidel and her colleagues (2014) shows that social effectiveness therapy (SET) can be impressively effective in reducing social anxiety.

The authors compared the effectiveness of exposure therapy and SET. They used self-reports, blinded clinical ratings, and blinded assessment of social behavior.

SET is a multicomponent treatment approach in contrast to exposure therapy alone. It consists of: (1) psychoeducation, (2) social skills training, (3) in vivo and/or imaginal exposure, and (4) programmed practice (see Turner et al., 1994, for further information).

106 individuals with SAD were randomized to exposure therapy, SET, or to a wait list control. The results of the treatments were as follows:

“Both interventions significantly reduced distress in comparison to the wait list control and at post-treatment, 67% of patients treated with SET and 54% of patients treated with exposure therapy alone no longer met diagnostic criteria for SAD . . .

Also,

When compared to exposure therapy alone, SET produced superior outcomes on measures of social skill and general clinical status . . . participants treated with SET or exposure reported clinically significant decreases on two measures of self-reported social anxiety and several measures of observed social behavior.”

The authors addressed several limitations in the existing literature:

“. . . First, we included direct observation of behavioral skill using several different behavioral tasks. Second, unlike most previous investigations, we assessed clinical significance as well as statistical significance, using a normative comparison group.”

So, exposure therapy and SET are both effective treatments for social anxiety, but SET may produce greater effects. In other words, people with SAD benefit the most from a combination of exposure therapy and social skills training.

Exposure is an essential component in the treatment of anxiety, and research shows that social skills training alone isn’t effective in improving social skills (Poniah & Hollon, 2008). The two approaches should be combined for the best results.

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Journal of Anxiety Disorders, 28 (8), 908-918 DOI: Beidel, D., Alfano, C., Kofler, M., Rao, P., Scharfstein, L., & Wong Sarver, N. (2014). The impact of social skills training for social anxiety disorder: A randomized controlled trial(8), 908-918 DOI: 10.1016/j.janxdis.2014.09.016

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