Identifying and targeting idiosyncratic cognitive processes in group therapy for social phobia: the case of Vumile

Abstract

“Vumile” was a patient in a cognitive therapy group that was designed for socially phobic African students and based on a therapy model developed by Clark and Wells. The case narrative shows how Vumile constructed a personal model of the factors maintaining his social phobia, and within the group and through homework challenged negative beliefs, reduced selfconsciousness and engaged in a range of previously avoided behaviors. A significant maintaining factor, spontaneous images of women looking at him with pity or mockery, was only identified in the last session. However, Vumile was able to use the skills he had learned to investigate this further and to correct these processes, which were distorting his experience of social interactions with women. Significant gains were made after the end of the formal treatment program and these are reflected in scores at follow-up on several self-report scales measuring anxiety, depression and various aspects of social phobic behavior and cognition.