Treatment of Social Anxiety Disorder: Mechanisms, Techniques, and Empirically Supported Interventions

Social anxiety disorder (SAD) is a prevalent condition negatively affecting one’s sense of self and interpersonal functioning. Relying on cognitive but integrating interpersonal and evolutionary models of SAD as our theoretical base, we review basic processes contributing to the maintenance of this condition (e.g., self-focused attention, imagery, avoidance), as well as the treatment techniques geared to modify such processes (e.g., exposure, attention modification, imagery rescripting). We discuss cognitive-behavioral treatments (CBT) as combining multiple treatment techniques into intervention “packages.” Next, we review the existing empirical evidence on the effectiveness of CBT. Although CBT has accumulated the most support as superior to other credible interventions, we suggest that many treatment challenges remain. We conclude by discussing the ways to enhance the efficacy of CBT for SAD. Specifically, we highlight the need to (a) elucidate the complex relationship between basic processes and techniques, (b) advance personalized interventions, and (c) include a more diverse and comprehensive array of outcome measures.