Cognitive Behavioral Group Therapy for Patients with Co-Existing Social Anxiety Disorder and Substance Use Disorders: A Pilot Study

Abstract

Social anxiety disorder (SAD) frequently co-occurs with substance use disorders (SUDs). Although the efficacy of separate cognitive behavioral treatments for each disorder has been widely documented, there is a dearth of studies investigating treatment outcome for patients with co-existing SAD and SUDs. This paper presents preliminary data from a pilot study that investigated whether cognitive behavioral group therapy-modified to explicitly address the link between social anxiety and substance use-could lead to reductions in social anxietyrelated symptoms and improvements in affect and unrealistic alcohol expectancies in a sample of 59 patients diagnosed with co-existing SAD and SUDs. Results indicated significant reductions across treatment in social anxiety-related symptoms and negative affect, whereas no changes in positive affect or unrealistic alcohol expectancies were found. The results warrant a randomized controlled trial to explore the specificity of these effects.

Identifying co-occurring substance use disorders in community mental health centres. Tailored approaches are needed

“…This is largely consistent with other epidemiological and clinical studies (53,57,62,69,227,(254)(255)(256). Although, in some studies people who seek psychiatric outpatient treatment for depression or anxiety and who have a co-occurring alcohol use disorder, seem to be predominantly female (257,258). Nevertheless, our findings suggest that people with co-occurring substance use disorders are a more vulnerable group and therapists should tailor their treatment plans accordingly.…”

Integrated Cognitive Behavioral Therapy for Comorbid Cannabis Use and Anxiety Disorders

“…We know of only one published study testing a treatment designed to treat co-occurring anxiety disorder (SAD) and cannabis dependence (Courbasson & Nishikawa, 2010). In that study, group cognitive-behavioral therapy (CBT) for SAD (Heimberg, 2002) was modified to include discussions of the relations between anxiety and substance use for patients with co-occurring SAD and a substance use disorder.…”

“…Patients with elevated anxiety tend to have poorer CUD outcomes after outpatient MET or MET-CBT for CUD (Buckner & Carroll, 2010). Prior attempts to combine anxiety treatment with substance use disorder treatment show promise (Courbasson & Nishikawa, 2010); yet, scores on anxiety measures remained in the clinical range post-treatment and treatment dropout rates were high. The clinical improvement shown by the two patients in our case studies suggests that ACCT may be a promising treatment for patients seeking treatment for comorbid CUD and anxiety disorders.…”