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Cognitive Behavior Therapy

Cognitive Behavioral Therapy (CBT) techniques have proven to be helpful in identifying fear and modifying the distorted thought processes.  The use of cognitive restructuring identifies the negative thought processes about the situational fear, evaluates the beliefs leading to the thoughts, and recognizes possible alternatives to restructure the negative thoughts and overcome fear.  Exposure therapy gradually exposes the individual to fear provoking situations allowing them to recognize the false beliefs they hold about the situation.  Social skills training directly addresses social deficits that lead to avoidant behavior. Exposure therapy in combination with social skills training helps the individual overcome fear and produce behavioral changes producing improvements in social reticence and reduce social anxiety.

During exposure therapy, the individual is taught relaxation techniques that reduce anxiety in fearful situations.  Learning the relaxation techniques aids in overcoming the avoidant behaviors brought on by the fear.  As the individual is exposed to their situational fear, anxiety symptoms rise, the relaxation techniques help reduce the anxiety to an acceptable level decreasing the desire to avoid the situation.  Facing the situation allows the individual to experience the situation and accept their beliefs were false and their fear is developed from the false beliefs.

APD individuals tend to have poor social skills because they fear negative reactions of others.  The aim is to reduce shyness, promote eye contact, use positive nonverbal cues, become more assertive, and improve listening skills.  Creating these behavioral changes, invites positive reactions from others in a social setting which increases self-confidence, reduces anxiety, and promotes feelings of acceptance.

Studies show that combining exposure therapy with social skills training showed that improvements in social reticence and a reduction in anxiety lasted for over three months after a ten week treatment.  Researchers believe that increasing treatment time frame has the potential of increasing the result or the individual permanently overcoming the fear and social anxiety.  Achieving these positive behavioral changes could produce a more positive outlook on life for the individual.  The avoidant behaviors would be decreased and the individual would find acceptance in what would previously torment them.  They would begin to enjoy a social life rather than avoid one.  When the individual displays a positive outlook, others around them tend to do the same enhancing their lifestyle.

Reference:

Sanislow, C. A., Bartolini, E., & Zoloth. (2012). Avoidant Personality Disorder. In V. S. Ramachandran (Ed.), Encyclopedia of Human Behavior, 2nd Ed. (pp. 257-266) Academic Press: San Diego.  Retrieved from:  http://wesscholar.wesleyan.edu/cgi/viewcontent.cgi?article=1111&context=div2facpubs

All treatments of mental disorders should be ethical, or not harmful to the patient. Because the patient is exposed to a situation that causes great fear, mental anguish, and physical incapacities due to a phobia, exposing the individual sets them up to experience unnecessary discomfort.  PTSD exposure therapy ranks above the most aversive treatment, yet the drop out rates of exposure therapy are lower then other therapies.  Those suffering from APD, sometimes claim that the exposure is much worse than living with the fear, however, exposure therapy tends to claim patients through the entire course of therapy more often than not.  During the exposure, the symptoms worsen causing a stronger fear within the individual that may not decrease through further treatment.  Additionally, if exposure therapy is not administered properly, there is a possibility of adverse reations to the treatment.  For instance, symptoms may worsen or new fears develop.  It is unethical and treatment outcome may be hindered.

Reference:

Anestis, J. C. (2009). Psychotherapy Brown Bag. Retrieved from http://www.typepad.com/services/trackback/6a010537101528970b01156f89e36d970c

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