Managing Social Anxiety Following Traumatic Brain Injury: A Cognitive Behavioural Program
Written by Janet Hodgson, Skye McDonald, Robyn Tate & Paul Gertler
“Managing Social Anxiety following traumatic Brain Injury” is an empirically tested program developed by Clinical Psychologists Janet Hodgkinson and Paul Gertler and Clinical Neuropsychologists Robyn Tate and Skye McDonald designed to provide standardised CBT for social anxiety in people who have brain damage from trauma and other neurological conditions. The manual incorporates the same procedures and principles underlying CBT programs for social anxiety designed for non-brain damaged populations. The difference with this manual is that the program has been specifically adapted to provide effective and simple CBT for social anxiety in people with cognitive impairment. To this end it contains: frequent repetition of information, visual aids, cue cards, session summaries, audio tapes, role plays, simplified cognitive techniques (i.e., self-instructional strategies), and in-session planning for the completion of homework tasks. In a small RCT, it has been demonstrated that this modified approach to CBT for social anxiety was effective in reducing social anxiety difficulties in people with mild to moderate traumatic brain injury and concomitant problems with attention, learning and executive function.
The manual details nine sessions of treatment that address affective, cognitive and behavioural components of social anxiety. In Session 1, a definition of social anxiety is provided, personal goals are identified and monitoring is instigated. Session 2 addresses physical feelings of anxiety and introduces relaxation strategies. Session 3-6 address cognitive components of social anxiety including the role of self-talk, cognitive errors and core beliefs. Sessions 7-8 focus more on behavioural components including graded exposure and assertiveness training. Session 9 provides a review of strategies to alleviate social anxiety and focuses on relapse prevention. Clear, simple, easy to read checklists, summary sheets and homework monitoring sheets that are freely available to copy, accompany each session in the manual. This CBT for Social Anxiety manual can be used in conjunction with social skills training and emotion perception training to provide a comprehensive approach to improving social functioning in people with brain injury. It also complements our manual for CBT to manage both depression and anxiety in people in people with acquired brain injuries.