Online treatment opens new possibilities for people with social anxiety

by Matt Erickson
An illustration in Marina Gershkovich's online program likens anxiety to a "monster" playing tug of war over a canyon.

(Medical Xpress)—Social anxiety disorder is one of the most common psychiatric disorders. But only one in five people who have the condition actually receive treatment for it. If you fear interaction with other people, then how do you build up the courage to call up a stranger on the phone and ask for help, let alone to go talk face-to-face with a therapist?

Marina Gershkovich may have an answer to this problem.

Gershkovich, a Drexel PhD student in clinical psychology, is evaluating a new way to deliver socially anxious people the they need: an innovative online self-help program she developed.

A member of the lab of psychology professors James Herbert, PhD and Evan Forman, PhD, Gershkovich is interested in solving a quandary for clinical psychologists. Proven, evidence-based treatments exist for disorder, but those treatments may not find their way to most people who need them. This is because of a variety of reasons: People may live in rural areas, far away from therapists offering treatment; some mental-health providers may not practice treatments supported by state-of-the-art research evidence; and people with social anxiety may shy away from seeking treatment because of their fears.

Gershkovich believes the online program she's developed can help overcome some of those roadblocks. Plus, it could be much more affordable than traditional in-person therapy.

"You can have a full-time job and get treatment," Gershkovich said. "It's anonymous. And you can face your fears gradually."

The online program lasts just eight weeks, but Gershkovich said she saw significant results in the she conducted for her master's thesis. For people with mild to moderate levels of social anxiety, the program resulted in decreased symptomology. In fact, some participants no longer met criteria for the disorder upon completion of the program. For those whose symptoms were more severe, the program served as a first step in getting them to a point where they felt comfortable seeking in-person help.

The program resembles an online class, with weekly modules that participants must complete in sequential order. The format allows for multimedia components such as illustrations and videos that aren't a part of traditional in-person therapy.

For example, as a voiceover from Herbert compares experiencing anxiety to a game of tug-of-war with a monster across a deep canyon, an illustration (drawn by Gershkovich) drives the point home.

"We talk about these metaphors in session," Gershkovich explains. "We say, 'Imagine this monster.' Now, in the internet program, you don't have to imagine it."

The principal scientifically based treatment for anxiety is exposure therapy: gradually exposing people more and more to the things that they fear, alleviating their anxiety bit by bit. That requires some accountability, to ensure that people are actually doing their "homework" and challenging themselves with exposure. That's why, in her pilot study, Gershkovich checked in with each participant once a week with a 10- to 15-minute therapy session via videoconference. This weekly videoconferencing time is also itself a mini-exposure for participants.

"They might know what they need to do, and they might want to do it," Gershkovich said, "but the issue is just getting them to do it."

Next up, for her dissertation, will be a study examining how effective the program can be even without the remote support of a therapist.

More information: Gershkovich is recruiting potential participants—people ages 18-65 experiencing significant social anxiety (trouble speaking in public, difficulty making friends, shyness) interested in free treatment. Drexel students, faculty or professional staff are eligible. People interested in taking part can visit an informational webpage, call 215.571.4257, or email drexel.selfhelp@gmail.com.

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RobertKarlStonjek
1 / 5 (1) Apr 01, 2014
These people seem to be confounding phobia with anxiety.
Phobia is an irrational and persistent fear;
Anxiety is a nervous state, in the case of social anxiety, it is anxiety induced by social situations.

There is no reason to assume that all Social Anxiety is caused by a phobia or fear, although that can certainly is a common cause. It is natural to have a higher degree of alertness when in the company of strangers. If this normal mechanism is particularly sensitive and if it occurs even with friends then you have Social Anxiety without any phobia or fear whatsoever.
RobertKarlStonjek
5 / 5 (1) Apr 01, 2014
My personal experience is exactly the later type having suffered with this condition all my life. But the natural mechanism is not triggered by interactions that are not in person ie face-to-face or via phone. Social media interaction is unaffected. For social phobia we would expect that any interaction, including via social media, would induce the fear.

Note that I am Owner and/or Moderator of 6 Yahoo! and 6 Facebook science forums with a total membership of just over 70,000 and have no social anxiety issues at all, but will feel anxiety that induces fatigue after half an hour or so even at family gatherings...
misard
2.5 / 5 (2) Apr 02, 2014
Well, the first time I had a major panic attack the doctor put me on xanax but it messed with my head really badly and I had memory issues. My discharge papers noted that while medicated by it I had little to no acknowledgement of externally inflicted bodily harm/pain. What I do remember is waking up the next day with a swollen ankle and multiple bruises that hurry like hell from walking into things or just letting the car door close on me.
Later, someone recommended me this treatment, and I'm very grateful with it, i can go anywhere i want without problem, no anxiety, no panic attacks, i'm a new person. Read this article, it helped me a lot : panicsolutionkey.com