Non-drug treatment for social phobia.

When controlled studies on currently available non-drug treatments for social phobia were reviewed, short-term effectiveness was evident for social skills training, exposure therapy and cognitive therapy. The combination of exposure and cognitive therapy may have some superiority over the separate treatments. Group therapy and individual therapy did not differ clearly in outcome, while attempts to match treatment and patient characteristics have so far failed to produce consistently better results. With follow-up periods of either less than a year or more than a year, the therapies reviewed appeared to lead to stable results, although the available data allowed no firm conclusions because of attrition and additional treatments during the follow-up period. Except for the recent landmark study by Heimberg and Liebowitz, cognitive behavior therapy has not been adequately compared to medication. Studies are needed to assess the value of cognitive behavior therapy in combination with medication and to explore the possibilities of self-help manuals in such combination studies.