Integrating Cognitive-Behavioral Therapy With Compassion-Focused Therapy for the Treatment of Social Anxiety Disorder: An Evidence-Based Case Study

Cognitive-behavioral therapy (CBT) is an evidence-based treatment for social anxiety disorder that has been found to elicit significant changes in process-based mechanisms (e.g., emotion regulation strategies), which subsequently lead to reductions in social anxiety and associated functional impairment; however, CBT may be less effective for socially anxious individuals experiencing high self-criticism and low self-compassion. Compassion-focused therapy (CFT) has been used to address these tendencies in socially anxious individuals, but research in this area is limited. The present case study examined changes in social anxiety symptoms, self-compassion, emotion regulation strategies, and functional impairment throughout the course of treatment with a young, Chinese American woman using a novel integration of CBT and CFT for social anxiety disorder. The client experienced significant reductions in social anxiety and functional impairment across treatment, which was accompanied by reductions in fear and avoidance ratings for feared social scenarios. Significant mechanistic changes were also observed, including decreases in maladaptive emotion regulation strategies (i.e., suppression, rumination) and increases in self-compassion and adaptive emotion regulation strategies (i.e., expressive engagement, cognitive reappraisal). Findings support the efficacy of integrating compassion-focused strategies with CBT for social anxiety for a young adult with prominent tendencies of self-criticism and low self-compassion.