The main goal of treatment is to decrease fear and phobic avoid-ance to a level that no longer causes significant distress or func-tional impairment. In some cases, treatment includes strategies for improving specific skill deficits as well. For example, indi-viduals with social phobia may lack adequate social skills and can sometimes benefit from social skills training. Likewise, some individuals with specific phobias of driving may have poor driv-ing skills if their fear prevented them from learning how to drive properly. Typically, effective treatment for social phobia lasts several months, although treatment of discrete social phobias (e.g., public speaking) may take less time. Specific phobias can usually be treated relatively quickly. In fact, for certain phobias, the vast majority of individuals are able to achieve clinically sig-nificant, long-lasting improvement in as little as one session of behavioral treatment.
Effective treatments fall into one of two main categories: pharmacological treatment and CBT. Pharmacological treatments have been used effectively for treating social phobia, although it is generally accepted that they are of limited utility for treating specific phobias. In contrast, CBT has been used with success for the treatment of specific and social phobias. Despite the existence of effective treatments, fewer than half of those who seek treat-ment in an anxiety disorders specialty clinic have previously re-ceived evidence-based treatments for their social anxiety (Rowa et al., 2000). Tables 50.2 and 50.3 summarize various treatments for social and specific phobias.