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Excerpt 2
John H. Greist, MD, James W. Jefferson, MD and David J. Katzelnick, MD

Social Anxiety Disorder: A Guide

(Excerpt 2)

Success rate of behavior therapy

Successful treatment of social anxiety disorder with behavior therapy depends on the frequency and duration of exposure to situations that bring on anxiety and avoidance. That can be problematic because some situations are difficult to arrange frequently and long enough for exposure to work. It would probably be difficult for an individual whose social anxiety is evoked by authority figures to arrange frequent and extended discussions with the boss. Some of these exposure sessions must be done in imagination rather than in real life. The effectiveness of imaginal exposure may be less than that of real life exposure.

Behavior therapy requires active patient participation in following treatment agreements and instructions. Just as penicillin must be taken properly in order to combat bacterial infections, behavior therapy must be done according to prescription in order to alleviate social anxiety.

Various studies show that at least half of social anxiety disorder patients benefit from behavior therapy. The amount of improvement can be quite substantial. A few patients become completely free of symptoms for the rest of their lives, but most will have recurrence of some symptoms from time to time. The most realistic expectation is that symptoms will be substantially reduced in both frequency and severity.

Because behavior therapy is a treatment patients can apply whenever necessary, the gains realized are usually maintained for many years, and often indefinitely.