SUCCESSFUL INTERDISCIPLINARY INTERVENTION WITH AN INITIALLY TREATMENT-RESISTANT SOCIAL PHOBIC

Despite very successful treatments for social phobia, with many studie s reporting as many as 75% of social phobics making clinically signifi cant gains with 3 months of treatment or less, some social phobics fai l to respond to treatment. This case presents a woman with social phob ia who received several trials of treatment for severe public-speaking fears but failed to improve, as demonstrated by persistent reports of fear and avoidance equal to those before treatment. With the assistan ce of a speech language pathologist, this client received combined the rapy that included cognitive-behavioral therapy to treat her public-sp eaking fear and avoidance and voice therapy to treat excessive muscle contractions in the respiratory and phonatory systems. Overall, the co mbined treatment was successful, with the client's self-reported level s of fear and avoidance of public speaking decreasing dramatically. Sp ecific improvements during voice therapy and implications for the trea tment of social phobia are also discussed.