​​Social Phobia Treatment

Psychology Today/Social Phobia 


The Child Anxiety Network/Social Phobia


Dr. Steven Pence is an anxiety specialist in the treatment of social phobia for both children and adults. Dr. Pence's office is located in Oakland County, Michigan. Dr. Pence treats social phobia with evidenced-based cognitive behavior therapy with emphasis on exposure response prevention (ERP) for both weekly therapy and intensive outpatient treatment programs. Social phobia is an anxiety disorder involving intense fear of certain social situations in which the person is afraid of being scrutinized, judged, or embarrassed in public. Social Phobia usually starts during the child or teen years (around age 13) and usually begins in childhood or adolescence. Children are prone to clinging behavior, tantrums, and even mutism. Social phobia affects over 7% of the population at any given time.

Symptoms of this disorder may include:
Very anxious about being with other people
Intense worry for days, weeks, or even months before an upcoming social situation
Extreme fear of being watched or judged by other
Excessive self-consciousness and anxiety in everyday social situations
Fear that you’ll act in ways that will embarrass or humiliate yourself
Fear that others will notice that you are nervous
Avoidance of social situations to a degree that limits your activities or disrupts your life
Body symptoms such as blushing, heavy sweating, nausea, trembling, or having a difficult time talking

Triggering symptoms may include:
Being introduced to other people
Having to say something in a formal, public situation
Meeting people in authority
Meeting other peoples’ eyes
Being the center of attention
Being teased or criticized
Swallowing, writing, talking, making phone calls
Being watched or observed doing something

About 20 percent of people with social anxiety disorder also suffer from alcohol abuse or dependence, and a recent study found that the two disorders have a stronger connection among women.

ERP (Exposure Response Prevention) is one of the most effective and highly researched modalities for the treatment of anxiety disorders. Exposure involves intentionally confronting situations that you know are likely to increase your fear and anxiety. Ritual prevention involves choosing to sit with your anxiety (without resisting it) and letting go of the unhelpful strategies (rituals) that are maintaining the cycle. When you do this, you will naturally feel more anxious at first. However, with time, repetition, and practice, your fear will decrease. Because fear is what maintains your symptoms and causes your attention to lock onto your physiology, decreases in fear will lead to decreases in your symptoms. Treatment starts with exposure to situations that cause mild to moderate anxiety, and as the patient habituates to these situations, he or she gradually works up to situations that cause greater anxiety. The individual gradually challenges all of his/her symptoms and learns healthier productive methods of coping with anxiety. Cognitive-behavioral therapy for social phobia involves learning how to control the physical symptoms of anxiety through relaxation techniques and breathing exercises while challenging negative, unhelpful thoughts that trigger and drive social anxiety by replacing them with more balanced views. Finally, CBT involves facing social situations that are feared in a gradual, systematic way, rather than avoiding them.

Lifestyle changes may include:
Avoiding or limiting caffeine
Drink only in moderation
Quit smoking
Get adequate sleep

36 percent of people with social anxiety disorder report symptoms for 10 or more years before seeking help

Social Anxiety Resources:


Specific Phobia is a lasting and unreasonable fear caused by the presence or thought of a specific object or situation that usually poses little or no actual danger. Exposure to the object or situation brings about an immediate reaction and causes intense anxiety.  Adults realize that their fear is irrational, yet they can not overcome it and may want to avoid the situation altogether. The stress of this fear can interfere with the person’s ability to function. 

Examples of specific phobias include: 
Situational such as flying, driving, being in closed places, or going over bridges
Natural environment such as storms, heights, or water
Blood-injection-injury such as fear of being injured or injections
Other phobias such as fear of falling down or fear of costumed characters

Symptoms of this disorder may include:
Excessive or irrational fear of a specific object or situation

Physical symptoms of anxiety or a panic attack: nausea, diarrhea, sweating, trembling, shortness of breath, feeling dizzy, or feeling like you are choking

Anticipatory anxiety in which you feel nervous ahead of time