Studying the Effectiveness of Emotion-Focused Therapy on Reducing Fear of Negative Evaluation and Psychological Distress in Women with Social Anxiety Disorder

Anxiety disorders are among the most common mental disorders in both primary care and clinical medicine. The existence of psychological distress in many people with social anxiety disorder has been confirmed. Symptoms of psychological distress include decreased concentration, restlessness, impaired intelligence, sleep disorders, isolation and loneliness, lethargy and weakness. Evidence has shown that people with social anxiety disorder have higher levels of mental disorders, such as depression, stress, and anxiety, than others. In addition, psychological distress is a strong predictor, stimulus, and motivator for exacerbating social anxiety disorder. Social anxiety disorder is one of the most common psychological disorders and the third most common mental disorder among the general population. This study aimed to evaluate the effectiveness of emotion–focused therapy in reducing the fear of negative evaluation and psychological distress in people with social anxiety disorder.

The study method was quasi–experimental, using a pretest–posttest design with a control group. The statistical population comprised all female clients with social anxiety disorder referring to private counseling centers and university counseling centers in Tehran City, Iran, in 2018. The samples were selected using convenience sampling. To conduct the research a call was made to conduct research in private and public counseling centers. Then, the Social Phobia Inventory (Connor et al., 2000) was completed by the clients of counseling centers in Tehran. Among the respondents, 16 volunteered women with a higher score than the cut–off point of this questionnaire were included in the study. In addition, the Structural Clinical Interview for Axis I Disorders (SCID–I) (First et al., 1997) was performed on all individuals. Finally, based on the questionnaire and interview results, 16 women entered the intervention process after fulfilling the research conditions and meeting inclusion and exclusion criteria. They were randomly assigned into the experimental and control groups (emotion–focused therapy) and control group. The inclusion criteria were a score of 19 or higher on the Social Phobia Inventory, a diagnosis of social anxiety based on Structural Clinical Interview for Axis I Disorders (SCID–I), an age range of 18–40 years, and not using any psychiatric medication. The experimental group participated in ten 90–minute sessions (one session per week) in emotion–focused therapy training sessions. During this, the control group did not receive any intervention and resumed their regular daily routine. The research instruments included the Negative Evaluation Fear Scale (Watson & Friend, 1969) and the Depression Anxiety and Stress Scale (Lovibond & Lovibond, 1995). Data analysis was done using descriptive statistics (mean and standard deviation) and inferential statistics (univariate covariance analysis) in SPSS version 22. The significance level of the tests was set at 0.05.

The findings showed that emotion–focused therapy was effective in reducing negative evaluation (p<0.001) and psychological distress (p<0.001) and its components: depression (p<0.001), stress (p<0.001), and anxiety (p<0.001).

Based on these results, emotion–focused therapy training in people with social anxiety disorder reduces fear of negative evaluation and psychological distress and provides a basis for improving the symptoms of social anxiety disorder.