Social Anxiety Disorder Case Study

Diagnosis

The diagnosis of Social Anxiety Disorder (SAD), also known as Social Phobia, appears to be the best diagnosis given the client’s symptoms. The client, Diane, shows anxiety and fear of scrutiny through nervous episodes that she said exclusively occurs in social situations, which fits Criterion A for SAD in the DSM-5. The client reportedly fears acting in a way that will be negatively evaluated by other teenagers and adults (i.e. fear of looking stupid when ordering at a restaurant), which fulfills Criterion B for this disorder. The client avoids going places in fear of having to talk to people she is unfamiliar with, fitting Criterion D regarding avoiding social situations out of fear and anxiety. The client’s father has stated that

CT is a type of psychological approach used as treatment for many different types of disorders such as anxiety or mood disorders. This approach focuses on the continuous assessment and self-monitoring of the individual, relaxation training, and cognitive restructuring. A specific CT plan that is well-known and widely used is proposed to be used on the client because this type of treatment will allow the client to work through her fears and anxieties. This was chosen over a biological approach such as an SSRI, because developed dependencies and high relapse rates are common in these. The proposed 7-step treatment plan would occur as follows: 1. Develop a model with client using her own thoughts, anxiety symptoms, attentional strategies, etc.; 2. Identify key safety behaviors and their adverse effects using role-playing with other patients. Have client interact in different social situations and have her try to figure out how to avoid using her safety behaviors; 3. Shifting focus of attention of client to an external social situation and have client self-monitor to see how she responds; 4. Show client video of her own safety behaviors and other times when she was socially anxious in order to show her how she actually looked; 5. Behavioral experiments where client has to learn how to deal with her feared social tasks; 6. Discussion about the

One study from 2013 titled “Sudden Gains in Cognitive Therapy and Interpersonal Therapy for Social Anxiety Disorder” shows support that CT will be an effective treatment in Diane’s case. This experiment looked at the treatment effects of both CT and Interpersonal Therapy (IPT). Participants were randomly assigned CT, IPT, or control group. The sample consisted of 67 patients, evenly split up between CT and IPT treatments. Participants in the sample had a primary diagnosis of SAD and were between 18 and 65 years of age and had to attend at least 7 treatments to be counted in the study. Individuals were given assessments to complete immediately before and after treatment, as well as a 12-month follow up assessment. Assessments consisted of self-report questionnaires that helped to track progress of overcoming social phobias, including assessing social anxiety, avoidance, and physiological symptoms. The CT treatment was based off of the 7-step treatment listed in the above section of proposed treatment. The IPT treatment was based off of the standard manual written and developed by Lipsitz and Markowithz (1996). This study measured success in gains, which was defined as a computer-generated score dividing pre-treatment to post-treatment by standard error; a gain was required to be above 25% of the before-gain-calculation-score. The researchers in this study found that 22.4%