Cognitive-Behavioural Intervention in a Case of Social Anxiety

Abstract

Social anxiety is a disorder characterised by intense fear of social situations in which the person is exposed to possible evaluation by other individuals, for example, public speaking. We present the case of a 21-year-old university student who comes to the clinic reporting problems with social interaction and insecurity. This behaviour is maintained by avoidance of social situations, mainly with strangers, which foster self-doubt. He presents negative automatic evaluative thoughts and physiological symptoms typical of anxiety. He faces situations with great difficulty, with the presence of ruminations and negative self-evaluation. The aim of the intervention, from a cognitive-behavioural perspective, is to optimise his social interactions by reducing social anxiety, increasing self-confidence and improving the patient's social skills and assertiveness. In addition to a semi-structured interview, the following instruments were used for the assessment: SCL-90, STAI, CORE-OM and NEO-FII. The intervention proposal included psychoeducation techniques on social anxiety, cognitive restructuring for automatic negative evaluative thoughts, behavioural rehearsal and live exposure to social situations and social skills training.  Pre- and post-treatment results show a decrease in both state and trait anxiety, a reduction in clinical symptomatology and an increase in well-being and general functioning. After therapy, there is a decrease in factors related to discomfort and social anxiety, as well as an increase in social relations and self-confidence.