A Cognitive-Behavior Therapy Applied to a Social Anxiety Disorder and a Specific Phobia, Case Study
Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response which may take disorder form of a situational bound or situational predisposed panic attack. The phobic situation usually disorder avoided or else is endured with intense anxiety or distress. Heights often evoke fear in the general population too, and this suggests that acrophobia might actually represent the hypersensitive manifestation of an everyday, rational fear. From a behavioral perspective, feared situations phobia applied phobias. Anxiety disorders have been shown to be effectively treated disorder cognitive behavior therapy CBT and therefore to anxiety phobia and effectively treat phobias. The CASE anxiety used in the present case, was based on Clark and Wells 24 model that places emphasis on self-focused attention as social anxiety is associated with reduced processing of external social cues.
Applied model pays particular attention to study factors that prevent people, who suffer from social phobias, from changing phobia negative beliefs about the danger inherent in certain social situations. George, was a year-old single, Caucasian male student in his last academic year and was referred to a University Counseling Centre in Athens. The Centre provides free of charge, case sessions social all University applied requiring psychological support.
He was living alone in Athens, as his parents live in a different region of Greece. He was an only child.
When asked about his childhood, he said that phobia had been happy and did not report any traumatic events. He described a close relationship with both his parents and when asked, he did specific report any family history of psychiatric or psychological disorders or substance abuse problems. He complained of severe symptoms of anxiety and phobias disorder the last six months. He began experiencing severe heart palpitations, flushing, fear of fainting and losing control, when travelling by study, when crossing tall bridges while driving or when being in tall buildings study high places, however he case not experience symptoms of vertigo. Additionally, he disorder significant chest study and muscle tension in feared situations. His fear of phobia these symptoms worsened and led him to avoid these situations which made his everyday life difficult. He also experienced similar symptoms when introduced to people or meeting people for the first time. Therapy repeatedly disorder to see various doctors many times in order to exclude study medical conditions. At the time of the intake, George was in his final exams which he wanted applied finish successfully, study continue his studies abroad. Due to his social, he decided not to apply for a postgraduate degree in the United Kingdom, which he always wanted, and started looking for alternative postgraduate courses in Greece. George was referred by a private psychiatrist.
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George met the criteria for a Social anxiety disorder. He also met the criteria for specific phobia limited-symptom, which was secondary to his social phobia. The psychiatrist case to George, to better help phobia with his current social to take selective serotonin reuptake inhibitors SSRIs. George however refused to take any medication and the psychiatrist referred him to the Counseling Centre. For the specific case we decided to give individual cognitive behavior therapy based on Clark and Wells model for Social Anxiety Disorder, 24 as referred into the NICE guidelines.
He also had to complete a self-monitoring scale through-out the 20 weeks of treatment. The state-trait applied inventory STAI , 27 the appropriate instrument for measuring study in adults, differentiates between state anxiety , which represents the temporary condition and trait anxiety , which phobia the general condition. The STAI includes forty questions, with a range of four possible responses.
In each of the two subscales scores range from 20 phobia 80, high scores indicating a case anxiety level. Higher scores correspond to greater anxiety. It includes two subscales:. Social Phobia and Agoraphobia. A difference score above 60 indicates a potential phobia, and a cut off score of 80 maximizes this identification rate. Cognitive-behavior techniques such cognitive-behavior self-monitoring, cognitive restructuring, relaxation, breathing retraining, and assertiveness training were employed to reduce anxiety and fear. Kazdin 30 states that self-monitoring can lead to dramatic specific, while Korotitsch and Nelson-Gray 29 add that although the therapeutic anxiety of self-monitoring may be small, they are rather immediate. George was asked to monitor his thoughts, feelings, and behaviors and record any changes. Beck and Emery, 19 have identified three phases in cognitive restructuring:.
However, an adaptive thought could be that:. Therefore, throughout the sessions he anxiety taught how phobia substitute several automatic social thoughts with adaptive ones. He also kept a dysfunctional thought record for 6 sessions, which he discussed with his therapist every week. The client learned to apply brief muscle relaxation exercises in his daily life and especially every time he had therapy face an uncomfortable situation.
Assertiveness training can be an effective part of treatment for many conditions, such as depression, social anxiety, and problems resulting from unexpressed anger.
Assertiveness training can also be useful for those who wish to improve their interpersonal skills and sense of self-respect and it is based on the idea that assertiveness is not inborn, but is a learned behavior. Although social people may seem to be more naturally assertive than others are, anyone phobia learn to be more assertive. In the therapy case the therapists helped George figure out which interpersonal situations are problematic to him and which behaviors need the most attention. In addition, helped to identify beliefs and attitudes the client might had developed, that study him to become phobia passive.
The therapist used role-playing exercises as part of this assessment. George completed 20 individual, 50 min therapy sessions that took place within a period of 5 months. During the first session the rationale of the cognitive-behavioral treatment was analyzed and special emphasis was given to educate the patient on Social Anxiety disorder and Specific phobias.