Cognitive-behavioral therapy (CBT) for the treatment of Social Anxiety Disorder (SAD) has demonstrated efficacy in numerous randomized trials. However, few studies specifically examine the applicability of such treatment for ethnic minority clients. Thus, the purpose of this article is to present two case studies examining the utility of individualized CBT for SAD with two clients who immigrated to the United States, one from Central America and one from China, for whom English was not their primary language. Both clients demonstrated improvement on a semi-structured interview and self-report measures. Necessary adaptations were modest, suggesting that therapy could be conducted in a culturally sensitive manner without much deviation from the treatment protocol. Results are discussed in terms of adapting treatment to enhance acceptability for and better fitting the needs of ethnic minority clients and non-native speakers of English. Implications for treating ethnic minority clients, as well as the practice of culturally sensitive treatment, are discussed.

A growing theoretical and research literature suggests that trait and state social anxiety can predict attentional patterns in the presence of emotional stimuli. The current study adds to this literature by examining the effects of state anxiety on visual attention and testing the vigilance-avoidance hypothesis, using a method of continuous visual attentional assessment. Participants were 91 undergraduate college students with high or low trait fear of negative evaluation (FNE), a core aspect of social anxiety, who were randomly assigned to either a high or low state anxiety condition. Participants engaged in a free view task in which pairs of emotional facial stimuli were presented and eye movements were continuously monitored. Overall, participants with high FNE avoided angry stimuli and participants with high state anxiety attended to positive stimuli. Participants with high state anxiety and high FNE were avoidant of angry faces, whereas participants with low state and low FNE exhibited a bias toward angry faces. The study provided partial support for the vigilance-avoidance hypothesis. The findings add to the mixed results in the literature that suggest that both positive and negative emotional stimuli may be important in understanding the complex attention patterns associated with social anxiety. Clinical implications and suggestions for future research are discussed.

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