Behavioral assessment and treatment of social phobia. An evaluative review.
This 1994 review warns that most social-phobia studies are too small, too mixed, and almost never include kids.
01Research in Context
What this study did
The authors read every behavioral study on social phobia they could find. They looked at how each study picked clients, what treatments were used, and how outcomes were tracked.
They focused on adults but noted a big gap: almost no data on kids. They also flagged small samples, mixed diagnoses, and weak measures.
What they found
The review says the evidence is too shaky to call any behavioral treatment solid. Too many studies lump different ages and problems together. Child data is nearly absent.
How this fits with other research
Dall et al. (1997) answered one of the review’s worries. They ran a clean RCT on adults and showed cognitive restructuring alone beats a control, giving the first clear piece on that part.
Bauman et al. (1996) added long-term proof the review wanted. They tracked clients for 18 months and found CBT gains stuck, no matter if exposure or cognitive work came first.
Bromley et al. (1998) fixed another gap the review named. They tested which questionnaires actually catch change after CBT and told clinicians to use SPAI or SPS/SIAS, not LSAS.
Why it matters
If you treat social anxiety, this paper is your caution sign. It tells you to check the age group, sample size, and measures in any study you cite. When you write a treatment plan for a child client, lean on newer kid-specific work, not the adult-heavy pile this review judged weak.
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02At a glance
03Original abstract
This article provides an empirically derived description of social phobia, including onset, prevalence, comorbidity, and issues of differential diagnosis. Assessment and behavioral treatment strategies for social phobia are reviewed. It was not until the past few years that structured clinical interviews and self-report inventories have been developed with adequate reliability and validity to specifically assess social phobia. Thus much of the treatment outcome research is confounded with heterogeneous samples that make generalization of results difficult to interpret. Heterogeneity of samples, lack of controlled comparisons with adequate statistical power to detect treatment differences, and inconsistent findings do not permit the drawing of any definitive conclusions concerning the efficacy of behavioral treatment procedures at this time. More treatment comparison studies for social phobia need to be performed using structured clinical interviews and standardized assessment devices specific for use with social phobia. Pre hoc power analyses should be performed to determine the number of subjects deemed adequate to detect differences when performing comparison studies. Assessment and treatment of social phobia with children is conspicuously nonexistent. Assessment and treatment procedures for social phobia need to be developed and standardized with children.
Behavior modification, 1994 · doi:10.1177/01454455940183002