Anne Marie Albano, Ph.D.

AnneMarie Albano Addresses

ACT on Treating Social Phobia

             From as far away as Camden County, twenty-three ACT members braved snow and freezing temperatures to attend  AnneMarie Albano’s workshop on Treating Social Phobia in Young Adults and Adolescents.

             Social phobics feel criticized and rejected, although they reject others first.  Avoiding social situations diminishes their anxiety, but interferes with mastering the developmental tasks of adolescence and young adulthood.  Young social phobics do not grow up to be happy, well-adjusted adults.  Dr. Albano recommended that therapists not blame social phobics for avoiding, but telling them that it takes two to have an interaction, and persuading them to take responsibility for initiating social contacts.

            A crucial issue in treatment is teaching social phobics to experience anxiety rather than avoid it.  Because they run away from anxiety, these patients  never learn that anxiety eventually diminishes.  Exposure is therefore a critical part of treatment.  Dr. Albano recommends doing exposure exercises during therapy sessions.  For example, the patient can make telephone calls from your office, or some therapy sessions can be held where the patient has the opportunity to interact with other people.

            Out of the office, you can model looking foolish or weird, being assertive, or talking to strangers.  Working behaviorally is particularly important early in treatment because this age group may not be able to talk about their cognitions or give accurate reports of their experiences.

            While the content of young people’s cognitive distortions is unique to their age, the disputations required to correct them are the same as with adults.  Teach these patients to question their assumptions and give them flash cards to record and practice disputations.  Encourage patients to be less judgmental and to focus on effort rather than outcome.  Prepare them for situations with action plans and always practice, practice, practice.

            Socially phobic youth are often bullied and teased.  Teach them to recognize the difference, and to ignore teasing.    

            Family members or significant others often make social phobia worse by modeling negative affect, voicing expectations of rejection and failure, and/or allowing the patient to avoid.  Encourage family members to let the patient experience and accept anxiety.  Encourage the family to reward courageous behavior, control their own anxiety, and communicate and problem solve with the patient. 

            Common cognitive distortions in social phobia include: 1) Social situations are dangerous; 2) I must perform perfectly to avoid these dangers; and 3) I lack the qualities the situation requires.  These people judge themselves harshly and others leniently.

                                                                                                                                             Lynn Mollick

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