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Managing Social Anxiety (Third Edition): Therapist Guide

Managing Social Anxiety – A Cognitive-Behavioral Therapy Approach comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the Client Workbook

Cognitive behavioral therapy (CBT) is an effective treatment for social anxiety. It is recommended by the National Institute for Health and Care Excellence (NICE, 2013). The Managing Social Anxiety: Therapist Guide (Third Edition) is written by Debra A. Hope, Richard G. Heimberg, and Cynthia L. Turk, and provides therapists with all the tools they need to deliver effective, evidence-based psychological treatment for social anxiety. Part of the Treatments That Work® series, the step-by-step approach is easy for beginning therapists to implement and offers many practical recommendations to help clients successfully engage with the treatment.

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Chapter 8: Exposure and Cognitive Restructuring: Ongoing Exposure

References

Front Matter

Appendix

Chapter 13: Termination

Chapter 12: Advanced Cognitive Restructuring

Chapter 11: Exposure and Cognitive Restructuring: Public Speaking Fears

Chapter 10: Exposure and Cognitive Restructuring: Conversation Fears

Chapter 9: Additional Tools for Challenging Automatic Thoughts

Introduction

Chapter 7: Exposure and Cognitive Restructuring: First Exposure

Chapter 6: Cognitive Restructuring: Challenging Automatic Thoughts

Chapter 5: Cognitive Restructuring: Learning About Cognitive Biases and Identifying Automatic Thoughts

Chapter 4: The Fear and Avoidance Hierarchy

Chapter 3: Psychoeducation: Etiology of Social Anxiety and Beginning to Monitor Progress

Chapter 2: Psychoeducation: Understanding the Nature of Social Anxiety and How to Manage It

Chapter 1: Psychoeducation: Background on Social Anxiety and Its Treatment

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  • English (GB)
  • English (US)

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Introduction & Theoretical Background

Social anxiety is one of the most common anxiety disorders (Kessler et al., 2005), affecting approximately 7.5% of individuals (Fehm et al., 2008). Left untreated, social anxiety can be a chronic and debilitating condition that significantly impacts peoples’ lives (Morrison & Heimberg, 2013). Symptoms of social anxiety include feeling anxious or fearful in social situations such as interactions with people, performing in front of others, or being observed. In addition, people with social anxiety are often concerned about being negatively evaluated which leads them to avoid social situations or endure them with intense anxiety. Managing Social Anxiety is a comprehensive program to assist clinicians in delivering effective CBT for social anxiety. The program includes two books:

  • Managing Social Anxiety: Therapist Guide details the step-by-step cognitive-behavioral treatment of social anxiety.
  • Managing Social Anxiety: Workbook is the companion to this guide. It will help your patients to become active participants in their treatment and learn how to address the thoughts and behaviours that maintain their social anxiety.

About Treatments That Work®

Authored by leading psychologists including David Barlow, Michelle Craske and Edna Foa, Treatments That Work® is a series of manuals and workbooks based on the principles of cognitive behavioral therapy (CBT). Each pair of books – therapist guide and workbook – contains step by step procedures for delivering evidence-based psychological interventions and will help you to provide the best possible care for your clients. At Psychology Tools, we are proud to make many of the Treatments That Work® titles available to our members. Each book is available to download chapter-by-chapter, and Psychology Tools members with a currently active subscription to our ‘Complete’ plan are licensed to share copies with their clients.

How effective is this treatment?

Several cognitive-behavioral accounts of social anxiety have been outlined, the most well-known being those proposed by Clarke and Wells (1995) and Rapee & Heimberg (1997). Both models have informed the development of cognitive behavioral therapy (CBT) for social anxiety, which has accumulated substantial evidence. CBT that has been specifically developed to treat social anxiety is recommended by the National Institute for Health and Care Excellence (NICE), which produces guidelines for the National Health Service in the United Kingdom (NICE, 2013). CBT for social anxiety has a strong evidence-base: research indicates that CBT for social anxiety is an effective psychological therapy (Canton et al., 2012) and the best initial treatment for social anxiety disorder (Mayo-Wilson et al., 2014).

Chapters in Managing Social Anxiety: Therapist Guide:

  • Introduction
  • Chapter 1: Psychoeducation: Background on Social Anxiety and Its Treatment
  • Chapter 2: Psychoeducation: Understanding the Nature of Social Anxiety and How to Manage It
  • Chapter 3: Psychoeducation: Etiology of Social Anxiety and Beginning to Monitor Progress
  • Chapter 4: The Fear and Avoidance Hierarchy
  • Chapter 5: Cognitive Restructuring: Learning About Cognitive Biases and Identifying Automatic Thoughts
  • Chapter 6: Cognitive Restructuring: Challenging Automatic Thoughts
  • Chapter 7: Exposure and Cognitive Restructuring: First Exposure
  • Chapter 8: Exposure and Cognitive Restructuring: Ongoing Exposure
  • Chapter 9: Additional Tools for Challenging Automatic Thoughts
  • Chapter 10: Exposure and Cognitive Restructuring: Conversation Fears
  • Chapter 11: Exposure and Cognitive Restructuring: Public Speaking Fears
  • Chapter 12: Advanced Cognitive Restructuring
  • Chapter 13: Termination
  • Appendix A: Assessment of Social Anxiety Disorder
  • Appendix B: Assessment Measures
  • References
  • Appendix

About the authors

Debra A. Hope received her PhD in clinical psychology from the State University of New York–Albany. Following an clinical internship in Philadelphia, she joined the faculty in the Department of Psychology at University of Nebraska – Lincoln. Professor Hope has published over 110 books and papers on topics related to social anxiety, cognitive– behavioral treatment (CBT), dissemination of evidence-based treatments, and the mental health impacts of stigma on gender and sexual minorities. Professor Hope is past president of the Association of Behavioral and Cognitive Therapies and past associate editor of Clinical Psychology: Science and Practice and Cognitive Therapy and Research. She teaches courses in psychotherapy and cultural diversity and supervises doctoral students in the Clinical Psychology Training Program clinic, where she directs two specialty services—the Anxiety Disorders Clinic and Rainbow Clinic. Professor Hope is a licensed clinical psychologist and maintains a small private practice.

Richard G. Heimberg is the Thaddeus L. Bolton Professor of Psychology at Temple University, where he also directs the Adult Anxiety Clinic. He is well known for his efforts to develop and evaluate models and treatments for social anxiety disorder. Dr. Heimberg has published 12 books and more than 450 papers on social anxiety, CBT, and related topics. He was recently listed among the top 1% of cited authors in his field according to Thomson Reuters, and he is past president of the Association for Behavioral and Cognitive Therapies (ABCT) and the Society for a Science of Clinical Psychology (SSCP), as well as being past editor of Behavior Therapy. He has also mentored over 60 clinical psychology doctoral students and several postdoctoral fellows and has received several mentoring awards: from ABCT (Outstanding Mentor 2006); the Society of Clinical Psychology (Toy Caldwell-Colbert Award for Distinguished Educator in Clinical Psychology, 2014); the American Psychological Association of Graduate Students (Raymond D. Fowler Award for Outstanding Contributions to Students’ Professional Development, 2015); and SSCP (Lawrence H. Cohen Outstanding Mentor Award, 2016). Dr. Heimberg was the inaugural recipient of the Academy of Cognitive Therapy’s A. T. Beck Award for Significant and Enduring Contribution to Cognitive Therapy (2001). He also received the Lifetime Achievement Award from the Philadelphia Behavior Therapy Association in 2016 and the Jerilyn Ross Clinician Advocate Award from the Anxiety and Depression Association of America in 2017.

Cynthia L. Turk, PhD is a professor in the Psychology Department at Washburn University, where she serves as the department chairperson. She is past president of the Southwestern Psychological Association, and has over 60 professional publications and over 100 professional presentations, primarily in the areas of social anxiety disorder and generalized anxiety disorder. She teaches graduate courses in psychopathology and psychotherapy techniques, and supervises master’s students in the Washburn University Psychological Services Clinic, where she directs the Anxiety Clinic. Dr. Turk is a licensed psychologist.

Therapist Guidance

Each Treatments That Work® title is published as part of a pair:

  • Clients use the Workbooks which contain elements of psychoeducation, skills development, self-assessment quizzes, homework exercises, and record forms.
  • Therapists use the Therapist Guides which contain step-by-step instructions for teaching clients skills and overcoming common difficulties.

The authors suggest that the most effective implementation of these exercises requires an understanding of the principles underlying the different procedures, and that mental health professionals should be familiar with the Managing Social Anxiety: Workbook as well as this therapist guide. Therapists with an active subscription to a Psychology Tools ‘Complete’ plan are licensed to use Treatments That Work® titles, and to download and share chapters with their clients.

References And Further Reading

  • Canton, J., Scott, K. M., & Glue, P. (2012). Optimal treatment of social phobia: Systematic review and meta-analysis. Neuropsychiatric Disease and Treatment, 8, 203-215. DOI: 2147/NDT.S23317.
  • Clarke, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment and treatment (pp. 69-93). Guilford Press.
  • Fehm, L., Beesdo, K., Jacobi, F., & Fiedler, A. (2008). Social anxiety disorder above and below the diagnostic threshold: prevalence, comorbidity and impairment in the general population. Social Psychiatry and Psychiatric Epidemiology, 43, 257-265. DOI: 10.1007/s00127-007-0299-4.
  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627. DOI: 10.1001/archpsyc.62.6.617.
  • Mayo-Wilson, E., Dias, S., Mavranezouli, I., Kew, K., Clark, D. M., Ades, A. E., & Pilling, S. (2014). Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. The Lancet Psychiatry,1, 368-376. DOI: 1016/S2215-0366(14)70329-3.
  • Morrison, A. S., & Heimberg, R. G. (2013). Social anxiety and social anxiety disorder. Annual Review of Clinical Psychology, 9, 249-274. DOI: 1146/annurev-clinpsy-050212-185631.
  • National Institute for Health and Care Excellence. (2013). Social anxiety disorder: Recognition, assessment, and treatment (NICE guideline CG159). https://www.nice.org.uk/guidance/cg159/chapter/recommendations#interventions-for-adults-with-social-anxiety-disorder-2.
  • Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour research and therapy, 35, 741-756. DOI: 1016/S0005-7967(97)00022-3.