Treatment of social phobia by exposure, cognitive restructuring, and homework assignments.

Seven patients who experienced clinically significant anxiety in situations involving public speaking or heterosexual performance and who had received a DMS-III diagnosis of social phobia participated in a 14-week program of cognitive-behavioral treatment. Treatment was conducted in a group format and consisted of: imaginal exposure, in which patients visualized their own participation in phobic events; performance-based exposure, in which patients enacted simulated phobic situations during sessions; cognitive restructuring, in which patients' cognitions experienced during exposure situations were assessed and analyzed; and systematic homework assignments involving the confrontation of environmental events previously simulated in the group. Self-report, behavioral, and physiological measures of anxiety were collected weekly during baseline and treatment periods, and additional measures were collected before and after treatment. After treatment, most patients demonstrated significant gains, and improvements were maintained at 3-month and 6-month follow-ups.