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Social Effectiveness Therapy Beats Social Anxiety, Study Shows
Social Effectiveness Therapy Beats Social Anxiety, Study Shows

Social Effectiveness Therapy Beats Social Anxiety, Study Shows

At some point in our lives, we all experience symptoms of anxiety. Public speaking or other unfamiliar situations can provoke natural feelings of anxiety. When these natural feelings turn into excessive anxiety and worry, they might be classified as an anxiety disorder.

In DSM-5, social anxiety disorder, also known as social phobia, is defined as a pronounced and persistent fear of scrutiny in social or performance situations, and it may account for up to 70% of all clients (Beidel et al., 2014).

SAD has its onset in adolescence and affects about 2% of the general population (Turner et al., 1994). SAD influences social, occupational and academic aspects of people’s lives.

Luckily, we can help people with SAD. A new study, a randomized controlled trial, by Deborah Beidel and her colleagues (2014) shows that social effectiveness therapy (SET) can be impressively effective in reducing social anxiety.

The authors compared the effectiveness of exposure therapy and SET. They used self-reports, blinded clinical ratings, and blinded assessment of social behavior.

SET is a multicomponent treatment approach in contrast to exposure therapy alone. It consists of: (1) psychoeducation, (2) social skills training, (3) in vivo and/or imaginal exposure, and (4) programmed practice (see Turner et al., 1994, for further information).

106 individuals with SAD were randomized to exposure therapy, SET, or to a wait list control. The results of the treatments were as follows:

“Both interventions significantly reduced distress in comparison to the wait list control and at post-treatment, 67% of patients treated with SET and 54% of patients treated with exposure therapy alone no longer met diagnostic criteria for SAD . . .


When compared to exposure therapy alone, SET produced superior outcomes on measures of social skill and general clinical status . . . participants treated with SET or exposure reported clinically significant decreases on two measures of self-reported social anxiety and several measures of observed social behavior.”

The authors addressed several limitations in the existing literature:

“. . . First, we included direct observation of behavioral skill using several different behavioral tasks. Second, unlike most previous investigations, we assessed clinical significance as well as statistical significance, using a normative comparison group.”

So, exposure therapy and SET are both effective treatments for social anxiety, but SET may produce greater effects. In other words, people with SAD benefit the most from a combination of exposure therapy and social skills training.

Exposure is an essential component in the treatment of anxiety, and research shows that social skills training alone isn’t effective in improving social skills (Poniah & Hollon, 2008). The two approaches should be combined for the best results.



Beidel, D., Alfano, C., Kofler, M., Rao, P., Scharfstein, L., & Wong Sarver, N. (2014). The impact of social skills training for social anxiety disorder: A randomized controlled trial Journal of Anxiety Disorders, 28 (8), 908-918 DOI: 10.1016/j.janxdis.2014.09.016
Image: David Shankbone


  1. Holly

    I think it sounds like a great program for people who suffer from anxiety phobias. It’s incredibly unhealthy to be in a constant state of stress. Short term anxiety increases your ability to remember and helps sharpen your immune system temporarily because the amygdala releases a fight or flight response. So it is helpful for short term, however if someone experiences anxiety for long term it can lead to memory loss, exhaustion, and a weakened immune system. There are different methods to help with stress, for example problem focused coping, (trying to find a solution to the problem), reappraisal, (reinterpreting a situation as less threatening), and emotion-focused coping, (regulating one’s emotional reaction). It is difficult for people who suffer from anxiety phobias to be able to do these by themselves though. With the combination of psychoeducation, social skills training, imaginal exposure, and programmed exposure should help anxiety patients immensely.

  2. Paige S.

    I think this is amazing, and am glad people with SAD are able to get help with their disorder and can enjoy life socially. Anxiety is a tough thing to live with and can inhibit people from going out and exploring. It is interested how some can effect them severely while others are effected mildly. This is the same as PTSD, some people have their whole lives “ruined” by this disorder, while others it doesn’t effect them as dramatically. Also, SAD can effect not only you but your freedom. If you’re in a legal case and have to take a polygraph test, you may fail just because you have SAD.

    1. Hi Paige,
      Yes, it’s amazing and promising. You’re right that some people experience mild anxiety symptoms, whereas others are plagued by anxiety. Anxiety may prevent people from living fully, going out or exploring life, as you say. If that’s the situation, I think people should seek help so that they can learn to deal with their anxiety more effectively. Yes, so true, a polygraph test is anxiety-provoking, even more for a person with SAD, and for this reason, the data it shows are not (always) reliable. That’s interesting.
      Best wishes,

  3. Katherine

    As someone who has dealt with SAD for a very long time, this article gives me some hope of at least being able to, for lack of better words, tone it down a little bit. Do you have any advice on where to begin to start a program like this? I feel like I’m trapped in the condition, but am open to any advice or help.

    1. Hi Katherine,
      Thanks for sharing!
      Have you sought any advice elsewhere? If you haven’t read this article, I think you would find it very useful: http://www.helpguide.org/articles/anxiety/social-anxiety-disorder-and-social-phobia.htm – In fact, many psychologists work with exposure therapy and social skills training, so that could be a possibility. I don’t know whether you have considered this as an option, but psychotherapy would most likely “tone it down”.
      Best wishes,

  4. Moriah

    After reading this I believe that set works so well because it includes multiple ways of coping with anxiety. My psychology book states a few of the coping methods such as social support, relaxation, exercise, and distraction. And set psychoeducation, social skills training, in vivo and/or imaginal exposure, and programmed practice. Those intertwine and help each other decrease anxiety.

    1. Hi Moriah,
      I’m glad you commented on this. I think, in most cases, a combination of techniques will give the best results as each technique (e.g., relaxation training or exercise) contributes to the therapeutic outcome. So, I think you’re right that the techniques intertwine, especially exposure and social skills training. The tool box has been increased, so to speak.
      Best wishes,

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