Psychology, Department of



Debra A. Hope

Date of this Version



Behav Ther. 2008 September ; 39(3): 286–299.


Published by Elsevier Ltd. Used by permission.


Exposure-based therapies have been considered the most efficacious treatments for social anxiety disorder (i.e., Gould et al., 1997). The majority of the theory behind exposure-based treatments rely on Foa and colleagues’s (Foa, Huppert, & Cahill, 2005; Foa & Kozak, 1986) emotional processing theory. However, there has been less research examining the way that emotional processing occurs across actual treatment sessions for clients with social anxiety disorder. This study utilized longitudinal data analytic methods to examine the changes in subjective anxiety during the first three exposure sessions in group and individual cognitive-behavioral therapy for social anxiety disorder. The results of this study provide preliminary evidence that while anxiety generally decreases across each exposure, some individuals experience considerable fluctuations in anxiety during a single exposure. Additionally, early exposures may be experienced differently than later exposures. Overall, this study highlights the importance of more fine-grained analyses to better understand the mechanisms underlying exposure-based therapy.

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