Treatments social skills training

CBT (exposure therapy, cognitive restructuring, relaxation training, and social skills training) and pharmacotherapy are considered equally effective in SAD, but CBT can lead to a greater likelihood of maintaining response after treatment termination. Even after response, most patients continue to experience more than minimal residual symptoms. 

Spence, S.H., Donovan, C., and Brechman-Toussaint, M. (2000) The treatment of childhood social phobia the effectiveness of a social skills training-based, cognitive-behavioral intervention, with and without parental involvement. J Child Psychol Psychiatry 41 713-726. 

Hoggarty, G.E., Anderson, C.M., Reiss, D.J., Kornblith, S.J., Green-wald, D.P., Javna, C.D., and Madonia, M.J. (1986) Family psychoeducation, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia. I. One-year effects of a controlled study on relapse and expressed emotions. Arch Gen Psychiatry 43 633-642. 

Although early anecdotal reports suggested the usefulness of this class of agents, overall studies of (3-blockers in clinical populations have not been supportive of their efficacy in social phobia. Falloon et al. [1981] compared propranolol and placebo, both used in conjunction with social skills training. This study failed to find any difference between the two treatment groups. However, the study was compromised by small sample size and failure to select subjects using specific diagnostic criteria for social phobia. 

Bellack, A.S., Hersen, M. Himmelhoch, J. Social skills training compared with pharmacotherapy and psychotherapy in the treatment of unipolar depression. Am. J. Psychiatry 138, 1562-1567, 1981. 

Application of social learning principles to reduce or eliminate alcohol consumption. Specific treatments include relapse prevention (discussed later in this chapter), community reinforcement, and social skills training (SST)—teaching the individual to use nonalcohol ways of coping with interpersonal situations. 

Every patient who uses tobacco should be offered at least brief treatment. All patients attempting tobacco cessation should be offered practical counseling (problem-solving/skills training), social support, stress management, and relapse prevention. 

The most effective types of counseling and behavioral therapies are (1) practical counseling employing problem solving and skills training, (2) social support as part of treatment, and (3) social support outside of treatment. 

Several recent documents provide excellent reviews of empirically supported treatments for childhood depression, anxiety, adhd, and disruptive behavior (Kazdin, 2000 U.S. Department of Health and Human Services, 1999). One treatment for depression, self-control therapy (Stark, Reynolds, Kaslow, 1987 Stark, Rouse, Livingston, 1991), reduces symptoms of depression and anxiety. Self-control therapy utilizes a cognitive-behavioral approach to group treatment and includes twenty-four 45-minute sessions. Sessions focus on restructuring maladaptive cognitions (e.g., ITl never win at anything) and training in social skills, assertiveness, and relaxation. 

A major barrier to the application of nonpharmacologic therapy is availability of treatment. CBT requires specific training. Many psychiatrists are not adequately trained and/or do not have the time or desire necessary to apply this therapy. Psychologists and social workers may have skills in this discipline however, the availability of their services is often restricted in certain areas. 

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