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The National Institute of Mental Health archives materials that are over 4 years old and no longer being updated. The content on this page is provided for historical reference purposes only and may not reflect current knowledge or information.

Behavioral Therapy Effectively Treats Children with Social Phobia

Science Update

A behavioral therapy designed to treat children diagnosed with social phobia  helped them overcome more of their symptoms than the antidepressant fluoxetine (Prozac), according to an NIMH-funded study published in the December 2007 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

Social phobia, also called social anxiety disorder, is characterized by an extremely distressing fear of social situations, of being watched or judged by others, and of being embarrassed. People with social phobia also may have physical symptoms like a racing heart, excessive sweating or blushing, trembling, nausea and other symptoms. Social phobia is more extreme than common shyness and can interfere with a person’s ability to function. Children with the disorder avoid everyday activities and situations such as playing with other kids, reading in class, and speaking to adults.

Deborah Beidel, Ph.D., of the University of Central Florida, and colleagues randomly assigned 139 children ages seven to 17 to one of three treatments—Social Effectiveness Therapy for Children (SET-C), fluoxetine or placebo (sugar pill). SET-C includes individual and group therapy sessions, plus a type of exposure therapy designed to reduce the children’s social anxiety and enhance their social skills. Antidepressants such as fluoxetine and other selective serotonin reuptake inhibitors are commonly used to treat social phobia in children, with typically favorable results.

Throughout the 12-week program, the children’s progress was tracked through self-reports, parent ratings and independent evaluators. Beidel and colleagues found that 79 percent of the children assigned to the SET-C group responded to the treatment, while 36 percent of the fluoxetine group responded, and 6 percent of the placebo group responded. In addition, when children were evaluated right after the program ended, 53 percent of the SET-C group no longer met criteria for social phobia, compared to 21 percent of the fluoxetine group, and 3 percent of the placebo group.

Overall, the researchers found that both SET-C and fluoxetine helped children overcome social distress. And although fewer children responded to fluoxetine treatment than SET-C, both groups maintained their gains at about the same rate one year after treatment ended. But SET-C also helped children overcome their fears and improve their general functioning and social skills, suggesting the behavioral intervention has a more comprehensive treatment effect.


Beidel D. Turner SM, Sallee FR, Ammerman RT, Crosby LA, Pathak S. SET-C versus fluoxetine in the treatment of childhood social phobia Journal of the American Academy of Child and Adolescent Psychiatry. 2007 Dec. 46(12): 1622-1632.