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Types >
Social Phobia
Brief description:
Children with social phobia are not just a little "shy," rather
they are painfully uncomfortable in any situation where they could be
embarrassed or feel they are being evaluated. They may see these threats
even in relatively safe situations. These children often wish they had
more friends but find it hard to do the things that are required to
make new friends or maintain these'friendships. Often time adolescents
will say they like being alone and don't need friends. For some kids
it's better not to know than take the risk they will be rejected.
Children with social anxiety appear uncomfortable and may choose to
withdraw or not talk to prevent the risk of embarrassment. They are
often successful at being invisible, in that while they may not actually
incur the social rejection that they fear, they may be unnoticed by
their peers and have a socially neglected status because of their voluntary
isolation, (eating lunch in the bathroom or alone at a table, avoiding
recess by going to the library or helping the teacher).
Red flags
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Fears being humiliated, embarrassing or laughed at in everyday
situations
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Avoid social contact or endures with great distress
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Physical symptoms of anxiety- racing heart, sweaty palms, difficulty
concentrating, stomachaches
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Avoid eye contact, conversation with others
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May be terrified of using the telephone, ordering in a restaurant,
eating in a cafeteria
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May be unable to raise a hand in class, do book reports or presentations,
or ask for help which would require being the focus of attention
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Avoidance of gym class or using school or public bathroom
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Hesitant to go to friend's houses or talk to friend's parents
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Exposure to the feared social situation almost invariably provokes
anxiety, which may take the form of a situationally based panic. In
children, the anxiety may be expressed by crying, tantrums, freezing,
or shrinking from contact. Persistent fear of one or more social or
performance situations in which the person is exposed to unfamiliar
people or to possible scrutiny by others.
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Clinically significant distress or impairment in important areas
of functioning.
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Duration of at least 6 months
Treatment focus:
The treatment focus for Social Phobia is similar to GAD with focus on
addressing physical symptoms, identifying anxious thoughts and development
of coping thoughts, and problem solving. Children learn that the worry
voice is a disruptive internal critic, by devaluing that voice and "firing
the judge," they can learn to turn attention away from self and toward
others and focus on the task rather than who is watching. The early
in vivo experiences may be smiling and making eye contact with a familiar
peer, later making a phone call to a peer to invite them over, and moving
up to giving a presentation in front of others.
