Telepsychology to Alleviate Social Anxiety Disorder

1. Feeling anxious in social occasions

2. Fearing negative evaluation when contacting with other people

3. Fearing to show foolishness when speaking and acting

4. Minding self-behaviors in front of others

5. Avoiding social occasions because of anxiety

6. Afraid to express idea

Susan has been harassed by Social Anxiety Disorder for years. She had to make calls to unfamiliar customers in her previous job. She felt scared and hesitated for quite a while before dialing the numbers. Besides, she would be very worried if she had to make public speech or report in front of her colleagues. If unavoidable, she would have spent many days to dig into the wording and recite the whole passage until remembering every word.

However, more preparation she made, more nervous and chaotic she would be in mind. Whenever she had conversation, she was frightened to say the wrong thing or fail to reply to the others. She also worried that she would be belittled by colleagues because of her foolishness.

Mind Broadening Behavioral Experiment – "Not Everyone is Paying Attention to Me” Susan knew about the Social Anxiety Internet Therapy launched by The Chinese University of Hong Kong and The University of Oxford and co-organized by the New Life Psychiatric Rehabilitation Association, was recruiting participants. Susan found similarity on her situation with the symptoms of Social Anxiety Disorder she read about in a promotional post. Out of curiosity, she signed up for the therapy.

The therapy last for three months. Participant would meet with Clinical Psychologist at the beginning and go through one treatment once in a week, online or over the phone. During the treatment, participant would be required to watch videos and read articles related to such disorder, the contents of which include different causes and process of mood disorders, sharing of stories from People in Recovery (PIR) of mental illness, how to improve the situation with Cognitive-Behavioral Therapy, and complete the assignment, such as finishing self-test questions and carrying out behavioral experiments. The clinical psychologist would also explain important information in the articles and video and reply to their questions and design personalized behavioral experiments.

Going through the treatment, Susan realized that the cause of her social anxiety disorder may be the "Excessive Self-awareness”, which leads to her over attention on her own behaviors and self-evaluation. "I was afraid to eat alone in restaurants, because others were all accompanied, and I felt I appeared to be strange for sitting by myself. One of the experiments designed for me was to try to eat alone in a restaurant and observe the reaction of people around me. I started to realize that there was not even a pair of eyes were on me, not to mention if I accidentally make any mistake or misbehavior.” Now, Susan understands that she has never been the focus of people around, and she finally builds up courage to make calls to strange people and initially talk to colleagues.

i Lee, Ng, Kwok, & Tsang. (2009). Prevalence and correlates of social fears in Hong Kong. Journal of Anxiety Disorders, 23(3), 327-332.

ii Wittchen, H., Stein, M., & Kessler, R. (1999). Social fears and social phobia in a community sample of adolescents and young adults: Prevalence, risk factors and co-morbidity. Psychological Medicine, 29(2), 309-323.

iii Ruscio, A., Brown, T., Chiu, W., Sareen, J., Stein, M., & Kessler, R. (2008). Social fears and social phobia in the USA: Results from the National Comorbidity Survey Replication. Psychological Medicine, 38(1), 15-28.

iv Lee, S., Lee, M. T. Y., & Kwok, K. (2005). A community-based telephone survey of social anxiety disorder in Hong Kong. Journal of Affective Disorders, 88, 183–186.