Typically, social anxiety disorder has been associated with social skills performance deficit, not a skill deficit, which suggests that individuals with social anxiety possess social skills, but they have difficulty performing in social situations. On the other hand, there is an indication that treatment options focusing solely on anxiety do not result in increased social functioning.
For example, the literature indicates that popular treatments targeting the social anxiety, not the social behavior, such as cognitive behavioral therapy (CBT) and exposure therapy (EXP) produce symptom improvements but social functioning remains impaired.
The importance of social skills training in social anxiety
In light of those findings, the current author suggests that the addition of social skills training to already existing treatments such as CBT and EXP could yield more effective results than any one treatment alone. Social effectiveness therapy (SET) is a form of social skills training that addresses both the anxiety and interpersonal skills. It incorporates role-playing, visual and in-vivo exposure to anxiety-inducing situations, and effective public speaking.
Comparing the effectiveness of SET versus EXP as a treatment intervention for social anxiety disorder led to interesting results. While both interventions produced a significant (i.e., a statistical term indicating that the results are not due to chance) reduction in anxiety and distress, exposure therapy (EXP) lacked clinically (i.e., in terms of clinical diagnosis) meaningful improvements in social functioning.
The author’s interpretation of those results implicate the importance of visual exposure (included in SET) before in-vivo exposure to help patients test various scenarios against their own negative expectations.
Beidel, D. C., Alfano, C. A., Kofler, M. J., Rao, P. A., Scharfstein, L., & Wong Sarver, N. (2014). The impact of social skills training for social anxiety disorder: a randomized controlled trial. Journal of anxiety disorders, 28(8), 908–918. https://doi.org/10.1016/j.janxdis.2014.09.016