Respond to your colleagues by suggesting an alternate therapeutic approach. Support your feedback with evidence-based literature and/or your own experiences with clients.
NOTE( Positive Comment)
Anxiety disorders are psychiatric conditions that share characteristics of excessive fear of real or perceived imminent threat. According to Thibaut (2017), anxiety disorders are the most prevalent psychiatric disorders- accounting for 7.3% of all psychiatric disorders worldwide. Anxiety disorders are distinguished from one another by the triggers that induce the anxiety, fear, or other associated behavior and may include generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, selective mutism, separation anxiety disorder, medication/substance-induced anxiety disorder, and social phobia (American Psychiatric Disorder, 2013; Thibaut, 2017).
A client I observed is N.B, a 15-year old male Caucasian presented to the clinic by his mother, who was concerned about his anxious behavior. The client’s mother described him as a shy person with little friends. For this reason, N.B spends most of his time playing video-games in his room. The client’s mother also revealed that N.B has always had problems meeting new people. During the interview, N.B looked uncomfortable. He could not keep eye contact and was fidgeting. N.B’s mother also revealed that he has always struggled in the presence of his peers. N.B has severally turned down his peer’s invitations to hang out and often engages in avoidance behaviors. After assessing the client, a diagnosis was made for social anxiety disorder (Social phobia) 300.23 (F40.10) (American Psychiatric Disorder, 2013).
The DSM-5 diagnostic criteria for social anxiety disorder (Social phobia) involves marked fear or anxiety of one or more social situations where an individual is exposed to scrutiny by others- (in peer settings for children). The social situations always provoke fear or anxiety and must have been lasting for six months or more. In the given case, the client met the diagnostic criteria for social anxiety disorder.
Therapeutic Approach and perceived Effectiveness
The most appropriate treatment for N.B is cognitive behavioral therapy (CBT). CBT is regarded as the approach with the highest level of evidence in the treatment of social anxiety disorder (Bandelow et al., 2017). CBT's goal in treating social anxiety disorder is to enable the client to gain self-consciousness by changing maladaptive behaviors and negative thoughts that make oneself uncomfortable in social situations. In their study, Pinjarkar et al. (2015) examined the effectiveness of CBT in treating social anxiety and found a clinically significant improvement in the subject’s self-consciousness and avoidance behavior (63.79%). In another study, David et al. (2014) concluded that cognitive therapy resulted in better outcomes than wait-list in the treatment of social anxiety disorder patients (78% of the subjects did not meet avoidant personality criteria at the end of treatment). The study also showed that cognitive-behavioral therapy was more superior to expressive and art therapy in the treatment of social anxiety disorder (71%) (David et al., 2014).
Thank you for listening to me.
I look forward to hearing from you on alternate therapeutic approaches.
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19(2), 93–107.
David M., C., Anke, E., Ann, H., Freda, M., Melanie, F., Nick, G., Louise, W., & Jennifer, W. (2014). Cognitive therapy versus exposure and applied relaxation in social phobia: A Randomized controlled trial. Journal of Consulting and Clinical Psychology, 74(3), 568–578.
Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in Clinical Neuroscience, 17(3), 337– 346.
Pinjarkar, R. G., Sudhir, P. M., & Math, S. B. (2015). Brief cognitive behavior therapy in patients with social anxiety disorder: A preliminary investigation. Indian Journal of Psychological Medicine, 37(1), 20–25. https://doi.org/10.4103/0253-7176.150808
Thibaut F. (2017). Anxiety disorders: A review of current literature. Dialogues in Clinical Neuroscience, 19(2), 87–88.