Social Phobia 369
client only recall certain negative aspects of the experience or is she able to recall more
positive information as well? What is the negative interpretation or conclusion that the
client makes about that social situation? What inference is drawn about herself and
about the risk of social interaction?
Individuals will differ in how much they recall past social failures when feeling
anxious. For some individuals there may be one or two events of intense embarrassment
that come to mind when they interact with others. For others it may be the accumulative
effect of many past social encounters which are recalled as very anxiety- provoking, even
embarrassing. Whatever the case, the cognitive therapist should assess the client’s recol-
lection and interpretation of past social events and determine their impact on current
levels of social anxiety. Gerald, for example, could not recall a particularly embarrass-
ing social failure experience. However, it was clear that he had a tendency to recall all
the negative and threatening aspects of past social experiences, even though cognitive
restructuring revealed that these experiences were not nearly as threatening or disas-
trous as Gerald remembered. These memories reinforced his beliefs that “he could not
handle being with people,” “that he was different from others,” and “that he would be
better off if he socially isolated himself.”
Core Social Self- Schemas
Assessment of the previous cognitive constructs of social phobia will allow the therapist
to specify individuals’ core beliefs about the self in relation to others. These social self-
schemas represent the end point of the cognitive case formulation and include how indi-
viduals believe they are seen by others. Table 9.5 lists a number of the core beliefs that
are found in social phobia. In the course of treatment a number of Gerald’s core social
self- beliefs became apparent. He believed that “others can see through me,” “people
tend to be harsh and rejecting,” “I become weak and pathetic in social situations,” and
“I can’t stand feeling anxious and uncomfortable around others.”
Clinician Guideline 9.16
A cognitive case formulation for social phobia should include (1) contextual analysis of
social situations; (2) focus on the anticipatory, exposure, and postevent processing phases
of social anxiety; (3) specification of the social threat interpretation bias; (4) assessment of
heightened self- consciousness and inhibition; (5) identification of safety- seeking responses;
(6) sampling of prominent social threat recall bias; and (7) specification of the core social
self- schemas.DesCription of Cognitive therapy for soCial phobiaThe primary objective of cognitive therapy for social phobia is to reduce anxiety and
eliminate feelings of shame or embarrassment as well as to facilitate improvement in
personal functioning in social evaluative situations by correcting the faulty appraisals
and beliefs of social threat and personal vulnerability. Table 9.7 presents the specific
cognitive treatment goals for social phobia.