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Nicky Shemian

on 20 February 2013

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By: Nicky Shemian Social Phobia Insight / Psychodynamic Therapy In psychodynamic / insight therapy I will work with Keshona on learning and understanding the ins and outs of her unconscious mind. She will reflect back on her childhood and find out why she is terrified of speaking in public. Some questions I may ask Keshona in one of our sessions are:
oWhat is the first thing that comes to mind when you hear the words “public speaking”?
oCan you think of a time when you felt extremely embarrassed? When?
oWhat is your first memory of feeling embarrassed or uncomfortable in public? Cognitive Behavioral Therapy In behavioral therapy Keshona and I will focus on changing the way she thinks and acts in social situations that she feels most discomfort, for example public speaking. In treating her psychological disorder, social phobia, I will not only focus on teaching her new ways of thinking (cognitive), but I will also practice approaching people (behavioral).
Group Therapy Biological Therapy Antidepressants, antianxiety and gabapentin (Neurontin) medication are usually what I prescribe my clients who are suffering from social phobia. With Keshona, I will prescribe her beta-adrenergic blockers (“beta blockers” which are used to treat actors and musicians who are stage fright. If this doesn’t help her, I will look at my list of other types of medications and see, which fits Keshona best.
Factors I would look into before choosing a medication for Keshona…
•Past treatment history
•Medical history
•Presence of additional psychological or medical problems
•Additional medication or substances being taken already KESHONA
“Keshona is terrified of speaking in public. Although highly knowledgeable and competent, whenever she has to address a gathering, her heart pounds, and her mouth gets dry.”

- Heart pounds
- Mouth gets dry

SOCIAL PHOBIA In group therapy Keshona will sit with others who are also suffering from social phobia. In the session, Keshona and my other clients will discuss their different approaches in treating social phobia. Systematic Desensitization In behavioral therapy, systematic desensitization is the best treatment for Keshona. In treating Keshona, I would first construct a hierarchy of anxiety-triggering speaking situations with her. Then I would use progressive relaxation and train Keshona to relax one muscle group after another, until she reaches a state of complete relaxation and comfort. Next, I would ask Keshona to imagine a situation in which she would feel a great amount of anxiety and discomfort. Once Keshona feels this discomfort, I would guide Keshona in going back to a complete state of comfort and forget about whatever it was that made her feel anxiety. This process will continue on to real-life situations and will slowly help Keshona conquer her fear of public speaking and even possibly raise her self-confidence. Ashbaugh, A. (2002). Retrieved fromhttp://anxiety.stjoes.ca/socialphobia.htm

Buggey, T. (2007, Summer). A Picture Is Worth .... Journal of Positive

Behavior Interventions, 9(3), 151-158. Retrieved December 14, 2007, from

Academic Search Premier database.

Myers, D., & Fineburg, A. (2011). Myer's psychology for ap: Teacher's edition.

US: Worth Publisher



coffee-shop.jpg (photo of “its difficult to speak”)


disorder-treatment.jpg (photo of “words just won’t come out”)


content/uploads/2012/02/social-anxiety-disorder.jpg (photo of microphone)

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