Treatment of Social Anxiety Disorder: A Case Study of an 11-Year-Old
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The following is a de-identified case study that presents the treatment process and outcome for Hannah, an 11-year-old female with social anxiety disorder, along with her mother, Debra (names and other details of the case have been changed for confidentiality). The client is an elementary school student residing in a midsize city in Midwest America. Hannah was seen at a community mental health center after being referred by her primary care provider. Hannah presented with severe anxiety symptoms that impacted her ability to interact with adults and peers. Hannah’s anxiety affected her cognitions, emotions, physiological symptoms, behaviors, and overall functioning. Consistent with the literature on empirically supported approaches to the treatment of anxiety in children, this therapist employed Cognitive Behavioral Therapy (CBT) to assist Hannah in learning skills to effectively manage and reduce her anxiety symptoms. The interventions included psychoeducation about anxiety, relaxation training, cognitive restructuring, and exposure therapy. This case study reviews the relevant scientific literature, initial interview, process of diagnosis, utilization of assessments to clarify diagnosis and measure treatment progress, development of treatment plan, implementation of the treatment interventions, and barriers to treatment. A transcription of one complete session is included to provide a glimpse into Hannah’s presentation in session and offer insights into how the therapist processed session content to make informed decisions regarding implementation of CBT-based treatment interventions. Hannah attended sessions regularly. Her compliance with homework assignments was inconsistent but she did engage in activities that challenged her social anxiety in her personal life such as ordering for herself at restaurants and engaging with adults and peers in one-on-one conversations. Treatment was still in progress during the writing of this report, and Hannah had made some treatment gains.