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Automatic Thoughts and Cognitive Restructuring in Cognitive Behavioral Group Therapy for Social Anxiety Disorder

Abstract

The goal in (Heimberg, R. G. (1991). A manual for conducting Cognitive Behavior Group Therapy for social phobia (2nd ed), Unpublished manuscript) cognitive behavioral group therapy (CBGT) for social anxiety disorder (social phobia) is to challenge irrational automatic thoughts and create exposures to provide disconfirming evidence for these irrational thoughts as well as habituation to fearful stimuli. Yet little is know about the types of thoughts reported by socially anxious individuals in therapy or which thoughts therapists select for cognitive restructuring in CBGT sessions. The present study analyzed the semantic content of automatic thoughts reported in CBGT and found that the most common thoughts related to poor social performance, negative labels by others, and the anticipation of negative outcomes in feared situations. Principle components analyses indicated the automatic thoughts reflected three underlying themes: Experiencing Anxiety, Negative Self-Evaluation, and Fear of Negative Evaluation. The paper also describes exploratory analyses of which thoughts became the focus of cognitive restructuring exercises and their relationship to treatment outcome. Implications for cognitive therapy are also discussed.

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Notes

  1. 1.

    Ethnicity is not assessed on the ADIS-R. Unfortunately, ethnicity is not available for these clients

  2. 2.

    Although portions of this study were conducted before the publication of DSM-IV (American Psychiatric Association, 1994), these participants would have met diagnostic criteria for social phobia under DSM-IV.

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Acknowledgements

The authors would like to thank Robin L. Treptow, Eileen Wade, and various research assistants for their assistance with coding and Alan Bellack for providing research assistant support. This study was supported in part by grant # MH48751 from the National Institute of Mental Health to the first author. Portions of this paper were presented at the presented at the 1995 annual meeting of the Association for the Advancement of Behavior Therapy, Washington DC.

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Correspondence to Debra A. Hope.

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Hope, D.A., Burns, J.A., Hayes, S.A. et al. Automatic Thoughts and Cognitive Restructuring in Cognitive Behavioral Group Therapy for Social Anxiety Disorder. Cogn Ther Res 34, 1–12 (2010). https://doi.org/10.1007/s10608-007-9147-9

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Keywords

  • Social Anxiety
  • Social Anxiety Disorder
  • Cognitive Restructuring
  • Phenelzine
  • Automatic Thought