Social phobia is a very common and debilitating disorder, with public speaking anxiety being
the most common fear. Psychologists have found that treating patients for their fear of
public speaking, through cognitive-behavioral treatment (talk-based therapy) or exposure
treatment (where participants participate in actual public speaking sessions), not only
helps patients overcome this fear but also helps them overcome their more general social
fears. However, little is known about how this change occurs during therapy. This study
tries to identify the factors that contribute most to successful therapy.
Patients are assigned randomly (like tossing a coin) to 1 of 3 groups. Group 1 will receive
cognitive-behavioral treatment and Group 2 will receive exposure treatment. Group 3 will not
receive treatment. Study leaders will monitor patient response to treatment through
behavioral tests and assessments.
An individual may be eligible for this study if he/she:
Has social phobia with public speaking anxiety.
The primary goal of the present study is to identify the mediators and moderators of change
in the treatment of social phobia and, in so doing suggest a common mechanism of action for
all brief psychosocial interventions. Perceived self-efficacy of social behavior, negative
cognitive appraisal (estimated social costs), and perceived emotional control will be
considered as potential mediators; avoidant personality disorder and the generalized subtype
of social phobia will be considered as potential predictors for poor treatment outcome.
Social phobia is a very prevalent and debilitating disorder, with public speaking anxiety
being the most common fear among socially phobic individuals. Although there are a number of
effective psychosocial treatments for social phobia (e.g., cognitive-behavioral treatments
and exposure therapy) very little is known about the underlying mechanism of therapeutic
change (i.e., the mediators of change), and the variables that are predictive of treatment
outcome (i.e., the moderators of change). Furthermore, it is unclear why treating
individuals for their public speaking anxiety can generalize to other untreated social
Patients are randomly assigned to either a comprehensive cognitive-behavioral treatment for
social phobia (n=43), a performance-based exposure treatment for public speaking anxiety
without cognitive intervention (n=43), or a waitlist control group (n=43). Clinician
ratings, behavioral tests, cognitive assessments, subjective ratings, and physiological
measures are employed to determine the degree of therapeutic gains in various social phobia
domains. The main hypothesis is that perceived emotional control will mediate treatment
outcome and generality of effectiveness independent of the specific treatment condition.
Patients must have:
Social phobia with public speaking anxiety.