Monica Ramirez Basco PhD University of Texas at Arlington Department of Psychology Fear of Social Situations Catastrophic Thinking Physiological Reactions to Social stress Avoidance Social Phobia ID: 911191
Download Presentation The PPT/PDF document "Cognitive-Behavior Therapy for Social Ph..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Cognitive-Behavior Therapy for Social Phobia
Monica Ramirez Basco, Ph.D.
University of Texas at Arlington
Department of Psychology
Slide2Fear of Social Situations
Catastrophic ThinkingPhysiological Reactions to Social stressAvoidance
Social Phobia
Slide3Specific or Generalized
Fear of public speakingFear of socializingAnticipates criticism or rejectionExpects embarrassment or humiliation
Social Phobia
Slide4Fear of social or performance situations
Exposure always provokes fearThe person knows its excessiveAvoids or endures with anxiety
Functional impairment
Duration at least 6 months in kids
Not illness or drugs
Unrelated to another disorder
Social Phobia
Slide5Fear of Most Social situations
Fear of Social ScrutinyInterferes with functioningRecognized as excessive
Generalized Social Phobia
Slide6Social Embarrassment
Eating in publicWriting in public
Performance Anxiety
Public Speaking
Musical Performance
Specific Social Phobia
Slide7Shyness
vs.
Social Phobia
vs.
Avoidant Personality Disorder
Continuum of Impairment
Slide8Social inhibition
Feelings of inadequacySensitive to criticism from othersCluster C:
Avoidant
Personality Disorder
Slide9Avoids work requiring contact with others
Fears criticismFears disapprovalFears rejection
Work
Slide10Avoids others unless certain that he or she will be liked
Social Contact
Slide11Holds back emotions
Shows restraintFear of criticismFear of embarrassment Intimacy
Slide12Is overly preoccupied with fear of criticism
Fears rejection by others in social situationsHates being the center of attentionSocial Scrutiny
Slide13Feels inadequate around others
Acts show or inhibitedThinks he or she is less worthy than othersInadequacy
Slide14Sees self as socially inept
Feels unattractive or unappealing Feels inferior to othersBehavior is withdrawn, avoids eye contactSelf-View
Slide15Reluctant to take risks
Doesn’t want to embarrass self Risk-taking
Slide16Avoidance in Social Phobia
Avoidance
Social Contact
Catastrophizing
Anxiety Reduced
Self-Criticism reinforces low confidence
Slide17Breaking the Cycle in Social Phobia
Avoidance
Social Contact
Catastrophizing
Anxiety Reduced
Self-Criticism reinforces low confidence
Slide18Avoidance in Social Phobia
Social Contact
Anxiety Reduced
Confidence
Increases
Rational Thinking &
Exposure
&
Slide19Develop Social Skills
Stop Catastrophic ThinkingReduce AnxietyStop Avoidance
Goals of
CBT for Social Phobia
Slide20The Cognitive Model
Thoughts
Feelings
Actions
Fear
Terror
Embarrassment
Obsession
Worry
Catastrophizing
Ritual or
Avoidance
Slide21Social Skills Training
Logical Analysis of Automatic ThoughtsDifferential RelaxationGraded In-vivo Exposure
Coping Skills Training
CBT Methods for Social Phobia
Slide22Explain how avoidance is a way of coping
Explain the negative reinforcement paradigmAvoidance helps you escape discomfortAvoidance lowers anxietyBecause it works, it increases the chance that you will use it again as a way of copingEvaluate the pros and cons of using avoidance as a way of copingAsk the patient if he or she would like to learn a new way to cope
Avoidance Coping
Slide23Instructions
How to say helloGetting a date
Making conversation
Behavioral Rehearsal w/Feedback
Practice with Safe Targets
Self-Monitoring
Graded Exposure
Social Skills Training
Slide24Learn the cognitive model
Monitor negative thoughtsRecognize catastrophizing and mind-readingAnalysis of negative thoughts
Rational responses
Decatastrophizing
NegativeThoughts
Slide25Identify sequence of catastrophic thoughts
People will look at meI will do something to embarrass myselfThey will laugh at meThe humiliation with be unbearableAssess the likelihood that this sequence will occurEvaluate the Evidence (reevaluate likelihood)Risk Management (reevaluate likelihood)
Plans for coping (reevaluate likelihood)
Decatastrophizing
Slide26Differential Relaxation
Learn standard relaxation inductionPractice maintaining relaxed state while involved in tasks
Normalize breathing
Muscle relaxation
Practice in non-threatening situations
Practice with graded in-vivo exposure
Slide27In vivo Exposure
Desensitization hierarchy developed
Start with the easiest item
Cognitive Rehearsal
Practice differential relaxation and decatastrophizing at each step
Slide28In-vivo Exposure
Construct desensitization hierarchyChoose an easy starting placePlan coping strategy
Troubleshoot
Assign as Homework
Follow-up and Repeat
Slide29I can’t tolerate rejection
Embarrassment is horribleI’m inadequateI have to be likedI’m unworthyI’m inferior to othersI can’t handle negative feedback
Schema Work
Slide30Historical analysis
Evaluate evidenceAdvantages and disadvantages of the schema“as if” exercisesRole play the alternative schemaIdentify alternatives
Interventions for Schemas