Harvard Mental Health Letter

In Brief: Weighing psychotherapy options for social anxiety disorder

Social anxiety disorder is sometimes dismissed as a severe case of "shyness," but this crippling disorder can interfere with work, school, and relationships. Multiple studies have concluded that cognitive behavioral therapy (CBT) helps many people manage social anxiety disorder, but little evidence exists about the efficacy of other types of psychotherapy.

Now a randomized controlled trial that compared CBT with interpersonal psychotherapy (IPT) has concluded that both are effective treatments for social anxiety disorder, but that more people respond to CBT.

Researchers in Germany and in England randomly assigned 106 people with social anxiety disorder to one of three groups: CBT, IPT, or a waiting list that served as the control. People assigned to CBT learned to shift the focus from themselves to other people and practiced role-playing exercises to improve their comfort in social situations. People assigned to IPT learned to identify the type of social interactions they found particularly daunting and then worked on ways to change them — so as to break the cycle of negative experiences that made them even more reluctant to meet or see other people.

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