Clark and Wells (1995) constructed a comprehensive cognitive model of social phobic behaviour, in terms of which social phobic behaviour is activated and maintained by a system consisting of negative thoughts and beliefs, anxiety s)mptoms, avoidance and safety behaviours, and processing of self as a social object. The interaction of these elements creates a series of vicious circles which escalate and which keep the phobic individual in a state of chronic -disability, either because they chronically avoid significant social situations or because they find themselves incapacitated by anxiety when they enter them. The Clark and Wells (1995) treatment programme is designed to alleviate the social phobia by targeting the components that form the vicious maintenance cycle and replacing these by new patterns of cognition and behaviour. This treatment programme was designed for individual treatment, and the present study adapted it to a group format. Seven social phobic university students participated in the adapted group treatment format over the course of 13, 2-hour group sessions. Regular assessment of participants' response to the programme was carried out weekly and at two follow-up assessments, with the use of a series of questionnaires. In addition, sessions were audio taped and videotaped, facilitators took notes during sessions and keep records made by participants of their homework exercises. Individual case studies were written for all participants (including two non-completers) in which case narratives were juxtaposed against their responses to each of the self-report questionnaires. These we used as a basis for evaluating the validity of the Clark and Wells theoretical model and in examining the effectiveness of the treatment programme in bringing to awareness and interrupting the cycles that maintained the phobic behaviour. It is concluded that the group programme showed evidence of being very effective and, a group treatment manual was constructed so that it can be employed clinically and in future research.

Thesis (PhD)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: The objective of this study was to investigate and compare the effectiveness of a combined exposure and cognitive restructuring programme versus exposure only in the treatment of social phobia. The 44 participants in the study met the DSM-IV diagnostic criteria for social phobia at pre-treatment assessment, and presented mainly with general interactional social fears. They were allocated to a group which received a combined exposure and cognitive restructuring treatment (n = 15), a group treated with exposure only (n = 15), and a waiting-list control group (n = 14). For treatment purposes, both treatment groups were subdivided into two smaller groups of 7 and 8 participants each. The effects and differential effects of the treatments were compared in terms of four broad categories of variables: target phobia variables (anxiety/avoidance/escape in relation to a specific target phobia), social phobia variables (associated with the degree, nature, aspects and/or consequences of social phobia), cognitive variables (thought functionality, fear-of-negative-evaluation, and attentional bias), and severity of depression. Participants were individually assessed before treatment, immediately after treatment, and at follow-up after three months. Treatment were conducted by two co-therapists in 12 weekly group sessions of two hours each. Compared to a waiting-list control condition, both treated groups showed a significant improvement of the target phobia variables at post-treatment and, with the exception of target phobia anxiety for the exposure only condition, the significant effects were maintained at follow-up after three months. As for the social phobia variables, cognitive restructuring and exposure combined showed a significantly larger improvement compared to the waiting-list control condition on four of the variables (social phobia avoidance, social phobia observation anxiety, social phobia general symptomatology, and social phobia disturbance/disablement), and these significant effects were maintained at follow-up. The exposure only group showed significantly larger effects on only two variables (social phobia avoidance and social phobia disturbance/disablement) and only the effects on social phobia avoidance were maintained for the followup period of three months. With regard to the cognitive variables, the combined treatment led to significanly larger improvements in thought functionality compared to the waiting-list control condition and these effects were maintained at follow-up. No other significant differences between the effects of any of the treatments and the waiting-list control condition were demonstrated at post-treatment or at follow-up on any of the cognitive variables. Only the combined treatment resulted in significantly larger reductions in the severity of depression, The effects were maintained for the follow-up period of three months. Compared to the waiting-list control condition, the combined treatment resulted in improvement over a broader spectrum of social phobia symptomatology than exposure only at post-treatment and follow-up. The two treatments were also directly compared in terms of their effects on each of the dependent variables and the differences were largely insignificant at both post-treatment and follow-up. Only in terms of thought functionality tentative indications of a possible larger effect for the combined treatment were found. However, if this was the case, the differences were cancelled out at follow-up. It seems that both the combined treatment and exposure only were effective treatments for social phobia and that the combined treatment might have demonstrated slightly better results. These findings support the emerging view that the most important cognitive-behavioral treatments of social phobia do not differ greatly in terms of efficacy. It also offer support for the view of prominent researchers on social phobia outcome, namely that treatment effects are less dependent on procedural variations than on other critical elements, such as the length and frequency of treatment sessions, and exposure to the critical elements of patients' social fears. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om die effektiwiteit van 'n gekombineerde blootstelling en kognitiewe herstruktureringsprogram teenoor blootstelling alleen in die behandeling van sosiale fobie te ondersoek en te vergelyk. Die 44 deelnemers aan die studie het voor behandeling aan die DSM-IV diagnostiese kriteria vir sosiale fobie voldoen en met oorwegend algemene interaksionele vrese gepresenteer. Hulle is verdeel in 'n groep wat met kognitiewe herstrukturering en blootstelling gekombineerd behandel is (n = 15), 'n groep wat slegs blootstelling ontvang het (n = 15), en 'n waglys-kontrolegroep (n = 14). Vir behandelingsdoeleindes is die behandelingsgroepe in twee subgroepe van onderskeidelik 7 en 8 deelnemers elk verdeel. Die effekte en differensiële effekte van die behandelings is in terme van die volgende vier breë kategorieë veranderlikes ondersoek: teikenfobie-veranderlikes (angslvermyding/ontsnapping ten opsigte van 'n spesifieke fobie), sosialefobie-veranderlikes (wat verband hou met die graad, aard, aspekte en/of gevolge van sosiale fobie), kognitiewe veranderlikes (gedagte-funksionaliteit, vrees-vir-negatiewe-evaluasie en aandagsverdraaiing), en graad van depressie. Deelnemers is individueel beoordeel voor behandeling, onmiddellik na afloop daarvan en na 'n 3- maande-opvolgperiode. Behandeling deur twee ko-terapeute het in 12 weeklikse groepsessies van twee uur elk geskied. In vergelyking met die waglys-kontrolekondisie, het beide behandelings tot 'n beduidende verbetering van die teikenfobie-veranderlikes by nameting gelei en, met uitsondering van teikenfobie-angs by die blootstellingsbehandeling, is die beduidende effekte vir 'n opvolgperiode van drie maande volgehou. Wat die sosialefobie-veranderlikes betref, het kognitiewe herstrukturering plus blootstelling 'n beduidend groter verbetering in vergelyking met die waglys-kontrolekondisie op vier veranderlikes (sosialefobievermyding, sosialefobie-observasie-angs, sosialefobie-algemenesimptomato/ogie, en sosialefobieongemak/ belemmering) tot gevolg gehad en is die beduidende effekte vir 'n opvolgperiode van drie maande volgehou. Daarenteen het die blootstellingsgroep slegs ten opsigte van twee veranderlikes (sosialefobie-vermyding en sosialefobie-ongemak/belemmering) tot beduidend groter effekte aanleiding gegee, waarvan die effekte net op een van die twee veranderlikes (sosialefobie-vermyding) vir 'n opvolgperiode van drie maande in stand gehou is. Ten opsigte van die kognitiewe veranderlikes, het kognitiewe herstrukturering plus blootstelling, in vergelyking met die waglys-kontrolekondisie, tot 'n beduidende verbetering van gedagte-funksionaliteit gelei wat vir 'n opvolgperiode van drie maande in stand gehou is. Geen ander beduidende verskille tussen die effekte van behandelings en die waglys-kontrolekondisie is vir enige van die ander kognitiewe veranderlikes by nameting of opvolg gedemonstreer nie. Slegs die gekombineerde behandeling het tot beduidend groter verlagings van die graad van depressie gelei wat vir 'n opvolgperiode van drie maande gehandhaaf is. In vergelyking met die waglys-kontrolekondisie, het die gekombineerde behandeling dus tot 'n beduidende verbetering oor 'n breër basis van sosialefobie-simptomatologie as blootstelling alleen by nameting en opvolg aanleiding gegee. Die twee behandelings is ook direk met mekaar in terme van effekte op elkeen van die afhanklike veranderlikes vergelyk en die verskille was by nameting en opvolg grootliks onbeduidend. Dit is slegs ten opsigte van gedagte-funksionaliteit dat daar tentatiewe aanduidings was dat die gekombineerde behandeling moontlik 'n beduidend groter verbeterende effek as blootstelling alleen kon gehad het, maar indien dit so was, was hierdie verskille by die opvolgmeting reeds uitgewis. Dit wil dus voorkom asof beide die gekombineerde behandeling en blootstelling alleen effektiewe behandelings vir sosiale fobie was en dat eersgenoemde dalk effens beter resultate kon gelewer het. Hierdie resultate ondersteun die standpunt wat tans besig is om op grond van navorsing te ontwikkel, naamlik dat daar nie betekenisvolle groot verskille in die effektiwiteit van die belangrikste kognitiefgedragsterapeutiese behandelings van sosiale fobie is nie. Dit bied ook steun vir die standpunt van prominente navorsers op die gebied van sosiale fobie uitkomsnavorsing dat behandelingseffek minder afhang van verskille in prosedure-variasies as van ander kritieke elemente, soos byvoorbeeld die lengte en frekwensie van die behandelingsessies en blootstelling aan die kritieke elemente van die sosiale vrese.

Thesis (Ph. D.)--Drexel University, 2005. / Includes abstract and vita. Includes bibliographical references (leaves 82-98).

Resumo: Os universitários são expostos a uma diversidade de situações sociais que repetidas vezes são enfrentadas com dificuldade e tentativas de esquiva, o que constitui fator de risco para a fobia social. Fobia social tem sido considerada um grave problema de saúde mental em função das incapacidades no desempenho em situações socias. A presente pesquisa tem por objetivo avaliar os efeitos de um procedimento de intervenção comportamental que inclui treino de habilidades sociais para universitários com fobia social. Foi utilizado um delineamento de linha de base múltipla com quatro universitários, sendo dois homens e duas mulheres, na faixa etária entre 19 e 31 anos, com diagnóstico de fobia social, sem comerbidades, obtido a partir da Entrevista Clínica Estruturada para o DSM-IV (SCID-I). Três universitários passaram pelo processo de intervenção e um respondeu apenas aos instrumentos, em diferentes momentos da pesquisa. As habilidades sociais e o diagnóstico do transtorno dos participantes foram avaliados antes da intervenção, após, e em seguimento, quatro meses depois, com a aplicação da SCID-I, do Mini-Inventário de Fobia Social (Mini-SPIN), do Questionário de Avaliação de Comportamento e Contextos de Vida para Estudantes Universitários (Q-ACC-VU) e do Inventário de Habilidades Sociais (IHS), instrumentos que avaliaram as medidas de produto. As medidas de processo, avaliadas a cada sessão, foram obtidas com a aplicação de uma lista de Verificação de comportamentos (checklist), Questões de Avaliação do Desempenho e Tarefas de Casa. O delineamento adotado foi o de linha de base multipla com sujeito único. A intervenção foi realizada no Centro de Psicologia Aplicada de uma universidade pública, contou com 12 encontros semanais com duas horas de duração conduzidos pela própria pesquisadora. Os resultados... (Resumo completo, clicar acesso eletrônico abaixo). / Abstract: The university students are exposed to a diversity of social situations that for frequent times ara confronted with difficulty and attempts of shunning, which constitute factor of risk to the social phobia. Social Phobia has been considered a serious mental health problem as a function of the disabilities in the development in social situations. The present research has as a goal to evaluate the effects of a behavioral intervention procedure which includes practice os social skills to university students with social phobia. An outline of multiple baseline was used with four university students, whose two men and two women, 19 and 31 year-old age group, diagnosed as social phobia, with no diseases, obtained from the Structured Clinical Interview to the DSM-IV (SCID-I). There univesitystudents went through the intervention process and one of them answered only to the instruments, in different moments of the research. The social skills and the diagnosis of the diasease of the participants were evaluated before the intervention, after, and in the sequence, four months later, with teh application of the SCID-I, of the Social Phobia Mini-Inventory (Mini-SPIN), of the Survey of Evaluation of Behaviors and Contexts of Life to University Students (Q-ACC-VU) and of the Inventory of Social Skills (IHS), instruments that evaluated the measurements of product. The measurements of process, evaluated in every section, were obtained with the application of a Behavior Checklist. Questions of Development and Homework Evaluation. The adopted outline was the one of a multiple base line with an only character. The intervention was held at Centro de Psicologia Aplicada in a public university, there were 12 weekly meetings for two hours each guided by the researcher herself. The results showed that the participants... (Complete abstract click electronic access below) / Orientador: Alessandra Turini Bolsoni-Silva / Coorientador: Ana Cláudia Moreira Almeida Verdu / Banca: Sonia Regina Loureiro / Banca: Sandra Regina Gimeniz-Paschoal / Mestre

Made available in DSpace on 2014-06-11T19:28:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-01-27Bitstream added on 2014-06-13T18:35:19Z : No. of bitstreams: 1 rocha_jf_me_bauru.pdf: 728958 bytes, checksum: af19223b07943e39abb4b152819659de (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Os universitários são expostos a uma diversidade de situações sociais que repetidas vezes são enfrentadas com dificuldade e tentativas de esquiva, o que constitui fator de risco para a fobia social. Fobia social tem sido considerada um grave problema de saúde mental em função das incapacidades no desempenho em situações socias. A presente pesquisa tem por objetivo avaliar os efeitos de um procedimento de intervenção comportamental que inclui treino de habilidades sociais para universitários com fobia social. Foi utilizado um delineamento de linha de base múltipla com quatro universitários, sendo dois homens e duas mulheres, na faixa etária entre 19 e 31 anos, com diagnóstico de fobia social, sem comerbidades, obtido a partir da Entrevista Clínica Estruturada para o DSM-IV (SCID-I). Três universitários passaram pelo processo de intervenção e um respondeu apenas aos instrumentos, em diferentes momentos da pesquisa. As habilidades sociais e o diagnóstico do transtorno dos participantes foram avaliados antes da intervenção, após, e em seguimento, quatro meses depois, com a aplicação da SCID-I, do Mini-Inventário de Fobia Social (Mini-SPIN), do Questionário de Avaliação de Comportamento e Contextos de Vida para Estudantes Universitários (Q-ACC-VU) e do Inventário de Habilidades Sociais (IHS), instrumentos que avaliaram as medidas de produto. As medidas de processo, avaliadas a cada sessão, foram obtidas com a aplicação de uma lista de Verificação de comportamentos (checklist), Questões de Avaliação do Desempenho e Tarefas de Casa. O delineamento adotado foi o de linha de base multipla com sujeito único. A intervenção foi realizada no Centro de Psicologia Aplicada de uma universidade pública, contou com 12 encontros semanais com duas horas de duração conduzidos pela própria pesquisadora. Os resultados... . / The university students are exposed to a diversity of social situations that for frequent times ara confronted with difficulty and attempts of shunning, which constitute factor of risk to the social phobia. Social Phobia has been considered a serious mental health problem as a function of the disabilities in the development in social situations. The present research has as a goal to evaluate the effects of a behavioral intervention procedure which includes practice os social skills to university students with social phobia. An outline of multiple baseline was used with four university students, whose two men and two women, 19 and 31 year-old age group, diagnosed as social phobia, with no diseases, obtained from the Structured Clinical Interview to the DSM-IV (SCID-I). There univesitystudents went through the intervention process and one of them answered only to the instruments, in different moments of the research. The social skills and the diagnosis of the diasease of the participants were evaluated before the intervention, after, and in the sequence, four months later, with teh application of the SCID-I, of the Social Phobia Mini-Inventory (Mini-SPIN), of the Survey of Evaluation of Behaviors and Contexts of Life to University Students (Q-ACC-VU) and of the Inventory of Social Skills (IHS), instruments that evaluated the measurements of product. The measurements of process, evaluated in every section, were obtained with the application of a Behavior Checklist. Questions of Development and Homework Evaluation. The adopted outline was the one of a multiple base line with an only character. The intervention was held at Centro de Psicologia Aplicada in a public university, there were 12 weekly meetings for two hours each guided by the researcher herself. The results showed that the participants... (Complete abstract click electronic access below)