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Persistent Family Stress in the Course of Cognitive-Behavioral Therapy for a 7-Year-Old Girl With Social Anxiety Disorder

This case study describes the use of cognitive-behavioral therapy (CBT) for a 7-year-old girl, “Lauren,” who was diagnosed with social anxiety disorder (SAD) and was experiencing significant family stress. Manualized CBT was conducted and substantial reductions in SAD symptoms and impairment were demonstrated. Given additional difficulties remaining in the home setting, booster sessions were continued following manualized treatment to target Lauren’s functioning at home. These follow-up sessions were associated with maintained functioning, and only minimal additional benefits emerged. This case study calls attention to the importance of considering family stress in individual CBT for children with SAD, as well as the difficulties associated with addressing family stress in CBT for SAD. Existing treatments do not routinely address family stress in the context of child SAD, despite the potential to enhance CBT outcomes for children with SAD.