The Value of Social Phobia Treatment in a Residential Environment
Unfortunately, the reasons why treatment is so important for those with social phobia are also common barriers to treatment. But a plan for comprehensive social anxiety disorder treatment is gradual and designed to care for the whole individual. This type of well-rounded treatment is most successful in a residential environment where clients can practice integrating new skills, progressive thought patterns, and coping strategies as they develop them in therapy.
Justin’s fear of being out in public has gotten so much worse over time. He remembers first feeling it when he was in school and had to stand up in front of the class to give a presentation or even just when he got called on and had to speak up and answer a question or introduce himself or ask to go to the restroom. Now, at 36 years old, he rarely leaves the house.
He worries about having people’s eyes on him when he crosses the street. What if he trips? What if they think that his clothes are too old and out of style? He worries about having to talk to the cashier at the store; what if he stutters or they judge how he signs his name on the credit card receipt.
Justin’s social anxiety disorder leads him to ponder and take personally all of the possible things that could go wrong when he has to do something in public. And when he actually does go out and has to socialize or accomplish even small things, his fear and anxiety become so debilitating that he sweats, feels his heart speeding up, confuses his words, and sometimes gets sick to his stomach. All of this makes him even more self-conscious and hyperaware of what others around him might be thinking of him.
His social phobia has put a strain on his ability to work in a public setting. It has made it nearly impossible to have a long-term romantic relationship, and even his relationships with family and close friends have become strained. The foremost thing he needs is social phobia treatment. But it is the last thing he wants; to put himself face-to-face with the opinions of treatment professionals is one of the most stressful situations he can imagine. Justin is one of the roughly 7% of people in the United States with social anxiety disorder, and it’s critical that we dissolve the barriers and make way for the treatment they need to reclaim their lives and fulfilling experiences in society.
Barriers to the Treatment of Social Anxiety Disorder
Someone with social phobia experiences paranoia and extensive preoccupation leading up to a task or event that will take place in the midst of other people. This anticipation only serves to build up those fears—even if someone has the positive intention of preparing themselves for any mistakes or other unfortunate eventualities. The fear and anxiety may reach such extreme proportions that they never even enter the fearful situation at all; they create an excuse or simply let the event pass and withdraw into their home environment. But even here, they experience anxiety, and avoiding distressing encounters doesn’t alleviate their experience of anxiety in the long run. Anxiously living in isolation to avoid others’ scrutiny is as much a devastating symptom of social phobia as is the acute anxiety felt in the midst of a social scene.
This same avoidance of exposure among people becomes a barrier to treatment because the offer of help challenges a person to come out of the seeming security of isolation. People with social phobia often have strong feelings of inadequacy around authority figures, so this prospect can be intimidating and even threatening. It can make treatment seem daunting with professional psychologists, psychiatrists, therapists, and counselors always there to observe and evaluate program participants. But the truth is that staff are there to listen and to make space for who each individual is. They understand that progress must take place in gradual stages and also that a client needs to find trust not just in others, but also in themselves.
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What You Can Expect from Social Phobia Treatment Options
Treatment for social phobia and anxiety will aim to revive a client’s self-esteem while empowering them with healthy coping mechanisms and social skills to manage their anxiety now and in the future. A professional diagnosis is necessary, considering a client’s physical, emotional, and behavioral symptoms. Based on that assessment, a comprehensive treatment plan will take into account co-occurring disorders such as depression or addiction, lifestyle, and the pace at which a client needs to approach progressive treatment challenges.
Antidepressants may be helpful in the context of comprehensive treatment for social phobia both because the side effects are relatively manageable and because co-occurring depression is common among those with social anxiety disorder. Medication for anxiety, including benzodiazepines may also be prescribed but under careful clinical supervision as they are highly addictive. And beta blockers may also be administered for management of the physical symptoms of anxiety.
Individual therapy is a critical piece of social phobia treatment because it addresses elements of the disorder that medication cannot resolve. Thinking patterns and experiences of past trauma must be witnessed and transformed if long-term, lasting healing is to take place. Cognitive behavioral therapy (CBT) is the primary therapy model for social anxiety disorder, but psychodynamic therapy and eye movement desensitization and reprocessing (EMDR) are also common and effective. When a trusting relationship develops between a client and a therapist—particularly in an inpatient environment, where the dynamic can develop gradually—the client can open up to their fearful experiences with compassion and with the tools to transform them.
Life and Social Skills Classes
Because so many people with social anxiety disorder are overwhelmed with daily life and have spent significant time in isolation, treatment classes that teach life and social skills can be valuable as clients are reconstructing their positive thought patterns and coping strategies for daily life. This kind of practice will help them to reintegrate different areas of life once the treatment program completes.
Holistic therapies and practices can empower clients to mitigate and manage their stress responses before they become overwhelming. It’s helpful to build healthy habits and thought patterns through peaceful, enjoyable activities such as art and music therapy, yoga and meditation, Tai Chi, massage therapy, equine therapy, and biofeedback. Clients can discover higher personal awareness, stress relief, and clearer emotional navigation.
Family and Couples Therapy
Family and couples therapy can also be a powerful piece of a comprehensive treatment plan. Especially as progress is being made in individual therapy, clients can focus more closely on their closest social connections, create healthier relational patterns, and reinforce their valuable support system for the recovery journey.
In a nonjudgmental group environment, clients can practice role-playing exercises and open conversations in which people feel able to be honest because criticism is expressly not a factor. This kind of exposure therapy in a group setting works for those with social phobia only when they can approach anxiety-inducing situations gradually, and a residential treatment setting allows for that gentle approach. It is particularly effective to experience cognitive behavioral therapy alongside group therapy sessions because clients are simultaneously gaining new skills and owning and practicing them for more sustainable results. Eventually, clients with social anxiety disorder will become more and more comfortable with social interactions in general and with more pressurized performance activities that they may be exposed to in the future. While these social encounters are inevitable, debilitating anxiety doesn’t have to be.
Uniquely Positive Opportunities of Social Phobia Treatment in a Residential Setting
In everyday life, there are too many distractions and triggers that keep someone with social phobia in their disordered patterns. A residential treatment environment offers an alternative setting for someone with social phobia to challenge their fears and automatic responses to stress. Stress is a given in life, but at least in this controlled and gentle setting, clients will not get set back so far when their anxiety does arise because they have extensive and well-rounded support from empathetic clinicians and therapists, and they are more likely to be able to maintain a realistic perspective in the context of these reminders.
Perhaps, in the past, people with social phobia have come up against others’ frustration—even the most caring people closest to them may not completely understand the depths of their disordered thinking and feeling. This frustration and alienation would have served only to push them further into their anxiety and isolation. This observation isn’t meant to put blame on those who haven’t been able to fully understand a loved one with social anxiety disorder; but it lends additional value to a residential treatment environment, where all in this caring community understand the complex and distressing experiences of social phobia sufferers. They take seriously the extent of clients’ fear and anxiety, as well as the importance of committed and comprehensive treatment for the individual and their past, present, and future experiences.
During an inpatient treatment program for social phobia, the attention will be constantly on recovery, and a client will have a unique chance to develop genuine compassion for their own experience. In fact, in the community setting, it can even be helpful to further grow their compassion and empathy with others because, in this way, others’ perspectives do not seem so foreign, so critical, rigid, or offensive. In this setting, their peers in treatment are navigating their own mental health challenges, and the context of universal human vulnerability becomes more accessible. These interactions and connections that previously served only to trigger someone’s anxiety now become the turning point for transforming fear and suspicion into trust and understanding.
Bridges to Recovery offers comprehensive treatment for people struggling with mental health disorders as well as process addictions. Contact us to learn more about our renowned Los Angeles and San Diego-based programs and how we can help you or your loved one start on the path to healing.