Abstract
Social anxiety disorder (SAD) is characterised by an intense fear about negative appraisal in social situations and is globally impairing for many individuals. The disorder is maintained by unique and deeply interconnected mechanisms, yet responds well to cognitive-behavioural therapy (CBT) programs specifically designed to address these mechanisms. In efforts to increase treatment access, participant retention, and speed of remission, intensive treatment programs have been investigated. This chapter reviews these programs and includes a case study of the only intensive treatment protocol for adolescents to date. In doing so, aspects of treatment that seem to work well, and not so well, are discussed. There is considerable variability amongst intensive programs in program content and delivery, and the literature is limited by a lack of studies in youth and randomised-controlled trials. Though some of the potential benefits mentioned above are not supported by evidence, other encouraging findings do emerge; intensive programs seem to be as effective as standard delivery formats in alleviating symptoms, intensive programs are appealing to busy families and may increase access, and they offer unique advantages regarding key treatment processes (habituation) and components (exposure). Recommendations are made for practitioners and researchers regarding treatment and areas of future investigation.
I have no known conflict of interest to disclose.
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Notes
- 1.
The evidence discussed in this chapter refers to the generalised form of SAD, which is global and pervasive. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) recognises a specifier of the disorder (performance only) that is impairing in a limited number of life domains, for example, only in one’s professional life (American Psychiatric Association, 2022). However, there is evidence to suggest that the performance only subtype is more akin to a specific phobia, and readers interested in the performance only subtype are recommended to consult the specific phobia chapter of this book for applicable guidance.
- 2.
The terms brief and intensive are used interchangeably in this chapter.
- 3.
Readers interested in a psychodynamic approach to intensive treatment for SAD (an uncommon approach far beyond the scope of this chapter) may refer to a study by Rahmani et al. (2020).
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O’Shannessy, D.M. (2024). Brief Treatments for Social Anxiety Disorder. In: Davis III, T.E., Storch, E.A. (eds) Brief CBT and Science-Based Tailoring for Children, Adolescents, and Young Adults. CBT: Science Into Practice. Springer, Cham. https://doi.org/10.1007/978-3-031-60746-2_10
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