Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial.

Abstract

A new cognitive therapy (CT) program was compared with an established behavioral treatment. Sixty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for social phobia were randomly assigned to CT, exposure plus applied relaxation (EXP AR), or wait-list (WAIT). CT and EXP AR were superior to WAIT on all measures. On measures of social phobia, CT led to greater improvement than did EXP AR. Percentages of patients who no longer met diagnostic criteria for social phobia at posttreatment-wait were as follows: 84% in CT, 42% in EXP AR, and 0% in WAIT. At the 1-year follow-up, differences in outcome persisted. In addition, patients in EXP AR were more likely to have sought additional treatment. Therapist effects were small and nonsignificant. CT appears to be superior to EXP AR in the treatment of social phobia.