Clinical Guidance: CBT vs. Psychodynamic Therapy for Social Anxiety Disorder
Both cognitive behavioral therapy (CBT) and targeted psychodynamic therapy improve symptoms of social anxiety disorder in large proportions of patients. In the comparison by Leichsenring et al. (p. 759), 25 treatment sessions produced response rates of 60% for CBT, 52% for supportive-expressive psychodynamic therapy, and 15% for a waiting list control condition. CBT is more likely to produce remission, but the response rate for psychodynamic therapy is comparable to rates for pharmacotherapy and group CBT. Milrod (p. 703) notes in her editorial that therapists should be vigilant for signs of separation anxiety and rage during termination, as these dynamics are frequent in social anxiety disorder patients.