Behavioral assessment and treatment of social phobia. An evaluative review.

This article provides an empirically derived description of social phobia, including onset, prevalence, comorbidity, and issues of differential diagnosis. Assessment and behavioral treatment strategies for social phobia are reviewed. It was not until the past few years that structured clinical interviews and self-report inventories have been developed with adequate reliability and validity to specifically assess social phobia. Thus much of the treatment outcome research is confounded with heterogeneous samples that make generalization of results difficult to interpret. Heterogeneity of samples, lack of controlled comparisons with adequate statistical power to detect treatment differences, and inconsistent findings do not permit the drawing of any definitive conclusions concerning the efficacy of behavioral treatment procedures at this time. More treatment comparison studies for social phobia need to be performed using structured clinical interviews and standardized assessment devices specific for use with social phobia. Pre hoc power analyses should be performed to determine the number of subjects deemed adequate to detect differences when performing comparison studies. Assessment and treatment of social phobia with children is conspicuously nonexistent. Assessment and treatment procedures for social phobia need to be developed and standardized with children.