Cognitive-behavioral treatment of social phobia: new advances.

Cognitive-behavioral treatment (CBT) for social phobia is an effective treatment for many patients, but some patients do not benefit from the treatments and many remain symptomatic. Therefore, researchers have been examining techniques that may improve treatment outcome. In this paper, recent psychopathology and treatment outcome research, much of which supports the expectation that a second-generation CBT treatment may further improve outcome, are discussed. Finally, the authors present a number of CBT techniques that are tailored for the individual treatment of patients with social phobia. These methods, based on comprehensive CBT developed by Foa et al. and on cognitive therapy for social phobia developed by Clark et al. include developing an idiographic model for the patient, conducting safety behaviors experiments, providing video feedback after cognitive preparation, developing a hierarchy, conducting in vivo exposures and other behavioral experiments, imaginal exposure, social skills training, assertiveness training, and behavioral activation for depression.