Social anxiety disorder (SAD) is a disabling condition. Individuals with SAD use behaviours to lessen their fears of negative judgement and danger and manage social situations better. Research suggests that SAD often co-occurs with other psychiatric disorders including substance use disorders. However, individuals are directed to seek treatment for SAD only after they have managed their other comorbid psychiatric problems. They are usually excluded from SAD treatment studies because of the belief that their concurrent disorders are a barrier to SAD treatment. Individuals with SAD may use avoidance strategies including substance use and problematic eating to manage their perception of danger in social situations. This presentation examines the efficacy of a 12-week CBT group modified for the treatment of concurrent SAD and substance use from existing CBT protocols for social anxiety (see Heimberg et al., 1999).

Participants with a DSM-IV diagnosis of SAD and substance use disorders were administered a series of social phobia, anxiety sensitivity, and expectancies on social evaluative situations pre and post SAD treatment. In addition, they completed weekly avoidance and fear hierarchies of social situations from pre to end of treatment. Treatment involved the identification and challenging of cognitive distortions, behavioural experiments and in vivo exposure.

Multiple comparison analyses suggested that individuals experienced a decrease in fear, avoidance, and physiological symptoms related to social anxiety.

CBT can reduce symptoms of SAD in substance users. Strategies to address substance use and problematic eating while delivering SAD treatment will be also presented.