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Social phobia (or social anxiety disorder), defined
A healthy way to explain social phobia to kids is to call it a 'worry problem'. Explain it in the context of being a 'worry problem' that can be overcome!
What happens is that intense feelings of shyness, self-consciousness or embarrassment build into a dominating fear. Consequently a person feels uncomfortable, even incapacitated, from participating in ordinary, everyday social situations. Such individuals may interact relatively comfortably with family and friends, but when starting a day at school, meeting new people, talking, speaking, drinking or eating in public begin to feel danger even though the danger is completely irrational. As a result, the classic physical sensations of fear; a faster heartbeat, a tightening throat and rapid breathing begin to form a part of the body's fight/ flight response. Common triggers also include worries that others are watching, fear about using the telephone, anxiety about the opinions others may hold and worry about making a fool of oneself in front of other people. Any of these, and more, can cause social phobia to kick in.
In reality, Social phobia relates to:
- Specific social phobia; social anxiety occurring only in specific situations (e.g. speaking in front of others).
- Social anxiety; emotional discomfort, fear or worry regarding social interactions with others (e.g. fearing being looked at or judged).
- Social anxiety disorder; a diagnosis by a mental health professional referring to clinically excessive social anxiety.
Social phobia is thought to affect about 10% of individuals at some point in their lives. It occurs in childhood and adolescence. Actually, according to the World Psychiatric Association (2005), about 40% of social phobias start in children before 10 years of age. About a third of 'school refusers' are thought to have social phobia.
Research suggests that social phobia is most likely inherited. However, environmental factors (family patterns and particular experiences) also influence the intensity and form of social phobia. What makes social phobia particularly tricky is that it is likely to be an underlying lifelong condition.
What is the best treatment for social anxiety?
The one thing that all socially anxious people share seems to bean understanding that their fears are basically irrational. Yet, despite this rational knowledge, they continue to feel and respond illogically. It appears Cognitive-Behavioural therapy is an effective treatment for social anxiety. Cognitive-Behavioural therapy guides children to reduce distortions in their thinking by substituting irrational thinking with more positive and rational thoughts.
A further treatment component is the explicit teaching of appropriate social skills to children to improve their social understandings, behaviours and responses. Children are taught to identify and change anxious thoughts by developing practical, positive strategies. This may include developing a list of situations that are challenging for them, and assigning exactly what to do when facing each of these situations. Ideal social skill approaches use modelling techniques, where appropriate skills are demonstrated by the therapist or facilitator, and then practiced with the child. Group treatment is often used, as it provides peers interaction and opportunities to learn from peers.
The inclusion of parents in treatment aids the maintenance of social phobia. Parents can learn how to cleverly take on the role of "coach" to help their child to apply their new skills at just the right time.
Helpful links
http://www.socialphobia.org/whatis.html#whatis1
http://www.socialanxietyassist.com.au/social_phobia.shtml
http://www.anxietyaustralia.com.au/article1.shtml
http://kidshealth.org/teen/your_mind/mental_health/social_phobia.html#