Some choose to begin with medication alone, in hopes of gaining at least some initial relief of symptoms before starting behavior therapy.
Still others want to start with behavior therapy, hoping to be content with the progress they make and add medication only if needed. Some patients begin treatment with medication and behavior therapy simultaneously.
For many, this combination approach is the best treatment.
Although no single approach is ideal for everyone, some therapists restrict themselves to one kind of treatment and don’t even consider others.
The skillful therapist will carefully assess each patient’s problems and attitudes toward treatment, and make recommendations based on that information plus knowledge of the available treatments.
Many forms of therapy that are still commonly used have not been found to be helpful in the treatment of social anxiety disorder.
Relaxation therapy teaches individuals techniques to decrease anxiety.
It has actually been studied carefully and found to be not helpful. In some situations it can even make social anxiety worse.
Beta-blockers have been found to be helpful for performance social anxiety disorder, but have not been found to be helpful for the generalized type of social anxiety disorder.
Many types of psychodynamic psychotherapy and hypnosis have not been systematically studied for their effectiveness in treating social anxiety disorder.
Almost all forms of psychotherapy that are helpful involve some form of exposure to social situations.
Electroconvulsive therapy (ECT) was tried in the past as a treatment for social anxiety disorder.
A great majority of the time, ECT was ineffective; it usually benefited only those patients whose social anxiety was associated with a major depression.
As ECT relieved the depression, the social anxiety also decreased.