A new study published in Behaviour Research and Therapy has good news for people with social anxiety: Don’t be discouraged if the treatment isn’t suddenly working in the first few weeks or even months.
Researchers analyzed data from two randomized clinical trials on social anxiety disorder and found that while some participants did not experience “sudden gains” in response to treatment, this factor did not limit their overall improvement long-term.
What does the term "sudden gains" mean? This term was first described in 1999 by researchers Tang & DeRubeis. Sudden gains are defined by three criteria:
- The improvement must be large in absolute terms.
- At least 25% of symptoms should be reduced before the gain occurred.
- The average level of symptoms in the first three therapy sessions before the gain must be higher than the average in the three therapy sessions afterward.
The first study of 68 participants with social anxiety disorder used individual cognitive-behavioral therapy (CBT) as the type of treatment. About 20% of participants in that study responded more quickly to treatment, qualifying for “sudden gains.” At one-year follow-up, however, those who had made “sudden gains” earlier in treatment did not have significantly more improvement in their social anxiety compared to those who had not.
In the second study, 100 participants with social anxiety disorder were treated with group cognitive behavior therapy (CBT) or Mindfulness-Based Stress Reduction (MBSR). About 30% of these participants experienced sudden gains. However, group with “sudden gains” again did not do better than the rest long-term.
This research serves as encouragement to people who are in treatment for social anxiety disorder and who may not be experiencing the immediate benefits they had hoped for. It is important not to give up on treatment of social anxiety just because it is not working in the first few weeks or months.
Being kind and patient with yourself is particularly important and helpful when you have social anxiety. It can be helpful to know that others are going through it as well and that treatment takes time. This research supports that it is normal that every individual has their own timeline to improve and if you put in the energy regularly, you will eventually see benefits. Much of treatment for social anxiety includes daily and weekly practice of skills and homework, including putting oneself in stressful situations, like public speaking or talking to new people at parties.
Social anxiety is a very treatable condition through a variety of therapy styles—and it’s helpful to know that research and clinical experience shows that just because you may not experience significant improvements early on, treatment can still work for you.
Copyright Marlynn Wei, MD © 2019