The Management of Social Anxiety: More Than 25 Years Later, Where are we?

Abstract

Behavioral and cognitive therapies are today the most effective toolbox and the most evidenced-based therapy for social anxiety. The purpose of this article is to provide an overview of some of the most popular methods for treating social anxiety. A selective review of literature published between 1997 and 2022 on social anxiety management. We have found that the majority of behavioral and cognitive treatment protocols are based on the following pillars: exposure to avoided situations, cognitive restructuring, assertiveness, and social skills training, as well as decentration techniques such as getting out of self-observation and cognitive fusion. Several psychotherapists agree on some components of social anxiety management while others do not. Within these agreements and disagreements, the path to the sketch of a new model should open. We argue that some techniques may ultimately be useless, counterproductive, and time-consuming. Alter the existing models and improve them in a different way in light of the multiple information and clinical examples is much needed. We suggest reconfiguring the theoretical and clinical elements to derive a new therapeutic combination of old techniques. In this new theoretical model of social anxiety, we scrupulously suggest including the cognitive and emotional elements and opt for primacy to be given to behavioral inhibition and the role of the biological part such as amygdala.