Effects of CBT intervention on chronic social anxiety disorder with fleeting delusional symptoms

Pages: 510-512
Mridula Apte (Clinical Psychologist, Vidula Psychological Consultancy, Deenanath Mangeshkar Hospital, Pune and Department of Psychology, Faculty, Savitribai Phule Pune University, Pune)
V. R. Shinde (Department of Psychology, Savitribai Phule Pune University, Pune, Maharashtra)
S. R. Barve (Consultant Psychologist, Vidula Psychological Consultancy, Pune, Maharashtra)

The effects of Cognitive Behaviour Therapy (CBT) on social anxiety have been well documented in scientific literature. A 19 year old girl hailing from upper middle socioeconomic status nuclear family , with professionally qualified parents, and no significant family history or past history, temperamentally quiet and shy, presented with symptoms of feeling extremely anxious with people around her, except her parents, leading to severe forms of avoidance behaviours, treatment at various places having yielded mixed and temporary results. CBT was used for this purpose, Behavior Therapy (BT) techniques like time scheduling, relaxation techniques, Systematic Desensitization(SD), in vivo exposure to social situations with co therapist, were used along with identification of errors, thought restructuring techniques, and psycho education about the problem as it has been chronic and the client was unable to comprehend it fully. Minimal dose of antidepressants was ongoing since several years. Treatment yielded positive results until client started reporting fleeting delusional symptoms intermittently. Psycho diagnostic assessment confirmed psychotic symptomatology of a delusional nature. Medication was started for the same. After an adequate period of medication, CBT was restarted and client responded well. Currently client has made a great deal of progress in terms of joining up for classes to learn new things, joining up for a regular college to finish her studies, client is also doing academically well there. Client has made new acquaintances, as well as a close friend in college. Treatment period lasted for over 2 years, and follow up is ongoing. Client continues to have anxious feelings while meeting new people, but tends to feel better in a short span of time, as against earlier.