The original Clark & Wells (1995) cognitive model of social phobia was a foundational step in development of Cognitive Behavioural Therapy (CBT) – see What is CBT?
For professionals:
The following link provides is to the original research paper (a subscription is required):
https://www.psychologytools.com/resource/cognitive-behavioral-model-of-social-phobia-clark-wells-1995/
Other versions of the original research paper are available across a wide range of subscription-based research services but we at SAAUK, cannot find a non-subscription version of the original paper.
Please also see this reference:
Clark, D. M. (2001). A cognitive perspective on social phobia : W. R. Crozier & L. E. Alden (Eds.), International handbook of social anxiety: Concepts, research and interventions relating to the self and shyness (pp. 405–430). John Wiley & Sons Ltd.
For general background:
Subsequent research has led to the refinement of treatment techniques but the original interventions included:
- Helping clients to develop specific and measurable goals for therapy.
- Helping clients to understand how the different components of the “model” maintain their anxiety.
- Changing safety behaviours and self-focused attention with behavioural experiments. Early approaches of the model might video-record the client taking part in two brief social interactions with a stranger: first while focusing attention on themselves, monitoring their performance, and using safety behaviours; and second, while focusing externally and dropping safety behaviours. Client ratings of their attention, anxiety, and self-consciousness would be taken and compared between both experiments.
- Attention training to shift the focus of attention prior to conducting specific behavioural experiments e.g. so the focus of attention is directed outwards rather inwards during conversations.
- Behavioural experiments to specifically test negative predictions and assumptions including negative self-images and self-impressions. Warnock-Parkes et al. (2020) recommend that while early experiments focus on dropping safety behaviours, experiments later in therapy focus on decatastrophising – intentionally testing what happens if the thing that the patient is afraid of were to happen (e.g. deliberately appearing sweaty in a conversation, deliberately saying something boring and monitoring other’s reactions).
- Handling anticipatory worry and post-event rumination. This might include exploring the advantages and disadvantages of worry & rumination, rehearsing answers to common worries, and switching to actively testing out worries by using behavioural experiments.
- Updating negative self-images and impressions. Warnock-Parkes et al (2020) suggest that attempts should be made to update self-images and impressions as part of information gathering during behavioural experiments. Some patients benefit from interventions which directly process and update their self-image, especially where such images are linked to past experiences of social trauma.
- Addressing dysfunctional negative beliefs and assumptions. The cognitive model suggests that dysfunctional assumptions predispose socially anxious individuals to appraise social situations in a negative light. These beliefs are addressed directly throughout the course of therapy to incorporate new information gathered from behavioural experiments and other interventions.