Social skills training versus cognitive therapy for social anxiety disorder characterized by fear of blushing, trembling, or sweating

Current interpersonal models suggest that social anxiety disorder (SAD) is characterized by interpersonal difficulties. Individuals with SAD and fear of showing bodily symptoms also suffer from interpersonal problems, such as not being open and avoidance of expressing insecurity. Training in social skills could, therefore, be an effective approach. We examined the overall and differential effects of social skills training (SST) versus cognitive therapy (CT) for social anxiety with fear of blushing, trembling, and sweating as the primary complaint. Patients (n = 55) with SAD (predominantly generalized subtype) and fear of blushing, trembling, or sweating as the main complaint were randomly assigned 12 weekly group sessions of SST or CT. Effects of treatments on fear of blushing, trembling, and sweating; SAD; social skills; social cognitions; and general psychopathology were assessed by means of self-report. Assessments took place at pretreatment, midtreatment, posttreatment, 1-month, and 1-year follow-up. Both treatments proved to be effective in the short and long-term, with large effect sizes. No differential effects were found. SST is a promising approach for individuals with SAD who fear displaying their bodily symptoms.