Concurrent alcoholism and social anxiety disorder: A first step toward developing effective treatments

Background: Social anxiety disorder (also called social phobia) is an anxie ty disorder in which affected individuals fear the scrutiny of others. Clin ical reports suggest that individuals with social anxiety disorder often us e alcohol to alleviate anxiety symptoms, a practice that leads to alcohol a buse and/or dependence in approximately 20% of affected individuals. The pr esent study investigated whether simultaneous treatment of social phobia an d alcoholism compared with treatment of alcoholism alone, improved alcohol use and social anxiety for clients with dual diagnoses of social anxiety di sorder and alcohol dependence. Methods: The design was a two-group, randomized clinical trial that used 12 weeks of individual cognitive behavioral therapy for alcoholism only (n = 44) or concurrent treatment for both alcohol and social anxiety problems (n = 49). Outcome data were collected at the end of 12 weeks of treatment and at 3 months after the end of treatment. Results: Results with intent-to-treat analyses showed that both groups impr oved on alcohol-related outcomes and social anxiety after treatment. With b aseline scores covaried, there was a significant effect of treatment group on several drinking measures. Counter to the hypothesis, the group treated for both alcohol and social anxiety problems had worse outcomes on three of the four alcohol use indices. No treatment group effects were observed on social anxiety indices. Conclusions: Implications for the staging of treatments for coexisting soci al phobia and alcoholism are discussed, as well as ways that modality of tr eatments might impact outcomes.