Wednesday, December 06, 2006

First Meeting of the Social Anxiety Study Group

Entry for 6 December 2006:

Last Thursday, 30 November, the Social Anxiety Study Group had its first meeting. Thanks partly to the announcement that Susan Cornforth placed on the PCT Scotland website for us, turn-out was surprisingly good: Eleven people, including Mick, Lorna, Beth, & Tracey; several participants from the PE-EFT-2 training workshop, and several other graduates of the Strathclyde Person-Centred Counseling Diploma. This was all the more surprising, because it was a very windy, stormy night. Here are some of my notes from the meeting:

A. Our immediate goals are as follows:
1. To develop a Person-Centred/Experiential (PCE) theoretical formulation of the sources and processes involved in Social Anxiety (SA) Difficulties.
2. To develop a practice formulation for how to work with clients suffering SA difficulties from a PCE perspective.
3. To develop a research protocol for an Open Clinical Trial (one group pre-post design) of one or more PCE therapies for SA difficulties.

B. We began discussing diagnostic issues. I noted that the field is in the process of moving away from Social Phobia, the older term, to Social Anxiety. The reasons for this change are not entirely clear, but does have the effect highlighting similarities between SA and other anxiety diagnoses, such as Panic Disorder, Generalized Anxiety Disorder, and Post-traumatic Stress Disorder. We also discussed issues of diagnosis from a PCE perspective, and how it might be possible to do diagnosis without compromising client or therapist integrity or the therapeutic relationship. There is controversy about this, with some (e.g., Pete Sanders) arguing on theoretical and political grounds that psychiatric diagnosis inevitably disempowers clients and sets therapist up as socially oppressive experts. Others (e.g., Elliott) argue from experience that there are effective methods for separating diagnosis from treatment and mitigating the potentially harmful effects of diagnosis. These include:
•Using the word “difficulties” rather than “disorder”
•Contextualizing diagnosis as a social construction, for both clients and therapists
•Teaching therapists how to “leave the diagnosis at the door”
•Familiarizing oneself with the full extent of the difficulties with psychiatric diagnosis but experiencing these for oneself.

C. An important point was the value of involving mental health service users in our planning process, via liaising with support networks such as (SA-UK). These organizations advocate for the development and use of effective treatments, currently mostly CBT, but could be valuable partners as a source of information and potentially referrals.

D. Interestingly, it became clear that most of us were past or current sufferers of Social Anxiety, the subject of our study. This is both a strength and a weakness: We can draw from our own lived experience, but we will be likely to expect the experience to be similar for others even when it’s not. In any case, this shared background makes it a good idea for us to begin with a heuristic research activity, i.e., writing 2 – 4 pages about our own personal experiences with social anxiety, including the following:
1. What was the experience was like for me?
2. What do I understand to have been the sources or causes of my anxiety and related difficulties?
3. What have I found useful in helping me cope with SA and related difficulties?
4. What have I found to be not helpful or even hindering for my dealing with SA and related difficulties?

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