Chapter 10 - Social Phobia

Abstract

This chapter discusses Social phobia. An age-related increase in social evaluative fears is part of normal development in children as they approach adolescence. For a small percentage of children and adolescents, however, social anxiety causes extreme distress and interference and cannot remit over time. For these individuals, social anxiety may lead to detrimental outcomes, such as depression, school refusal, conduct problems, and substance abuse. If left untreated, social phobia can lead to persistent problems with anxiety and depression in adulthood. Social phobia can be define as a marked and persistent fear of social or performance situations in which embarrassment or humiliation may occur. For children and adolescents with social phobia, exposure to social or performance situations frequently provokes an immediate anxiety response that is excessive or unreasonable. The average age of onset for social phobia is considered to be mid-adolescence coinciding with the normal vulnerability to social embarrassment seen in adolescents. Empirically supported treatments for social phobia in children and adolescents primarily involve the use of behavioral or cognitive-behavioral strategies. One such treatment for use with pre-adolescent children is Social Effectiveness Therapy for Children (SET-C). In addition to assisting in treatment planning, case conceptualization can provide a useful framework for evaluation of treatment progress. Case conceptualization serves to guide the therapist in the understanding, assessing, and treating a given child and his or her family, and social context. Without an adequate conceptualization, treatment is likely to falter. Moreover, it should be stressed that conceptualization must be highly individualized; not all cases of social phobia will respond to the same set of interventions.