Supervised by Dr. M. Anisur Rahman
Abstract
The present study was carried out to investigate the efficacy of cognitive behaviour therapy (CBT) in the management of social anxiety disorder with four specific objectives; to see the impact of CBT in reducing safety behaviours of the individual with social anxiety disorder, to find out the impact of CBT for reducing the negative automatic thoughts and core beliefs of the clients with social anxiety disorder, to find out whether cognitive behaviour therapy can bring about any positive change in the functional levels of the subjects of the study viz; social, educational/occupational, familial/personal, physical, emotional, and sexual; and to find out whether psychological management can bring about any positive change in the people with social anxiety disorder. It was hypothesized that cognitive behaviour therapy is effective in managing social anxiety disorder. Systematic case study design was used to test the hypothesis. Nine male subjects with social anxiety disorder diagnosed by the psychiatrist on the basis of DSM-IV TR (2000), constituted the research sample purposively collected from Psychiatric Departments of Bangabandhu Sheikh Mujib Medical University (BSMMU) & Dhaka Medical College & Hospital (DMCH) and the Students' Counseling & Guidance office of Dhaka University. The participants were free from psychiatric medication during the psychological management. They were from different socioeconomic status ranging from lower to upper class. Their age range was 19 to 30 years and their average age was 24.78 years. One of the respondents was married and the rest eight were unmarried. For collecting the data the researcher used in-depth interview, observation. Depression Scale (DS, Uddin & Rahman, 2005), Social Avoidance and Distress Scale(SADS, Watson & Fried, 1969), 11-point self rating scale, psychiatric rating and assessment of functional level in the above mention six sectors. Semi structured session format and treatment guideline were prepared for the subjects by the researcher. According to the guideline they were given more or less 14 sessions of cognitive behavioral therapy which arose from Clark and Well’s (1995) cognitive model of social anxiety disorder. The researcher assessed the clients in three phases viz; assessment phase, last treatment session and follow up session. The findings of this study cvinccd that significant improvement of social anxiety symptoms of the subjects took place as reported by the participants, two psychiatrists and observed by the researcher. The frequency of safety behaviours decreased. Negative automatic thoughts and core beliefs were transformed into positive direction. Marked improvement was also noticed in functional level of the clients in six sectors viz; social, educational/occupational, familial/personal, physical, emotional and sexual. The impact of CBT on the client clinical condition lowered their scores of Social Avoidance and Distress Scale (SADS) and Depression scale (DS). The respondents' subjective report on the II-point rating scale also showed noticeable improvement. So, it may be concluded that the subjects of the present study evinced overall improvement of their social anxiety disorder symptoms following employment of cognitive behaviour therapy. Thus, the findings of the study confirmed the hypothesis that cognitive behaviour therapy is efficacious in the management of social anxiety disorder.