Does behavioral treatment of social phobia lead to cognitive changes?

Little is known about specific effects of behavioral and cognitive treatment methods. The goal of this study was to examine the effect of a "pure" performance-based exposure treatment (i.e., without cognitive intervention) on the anxiety-related cognitions of subjects with social phobia (public speaking anxiety). Thirty-six such persons were recruited. Pairs of subjects matched by age, sex, and severity of phobia were randomly assigned to either a treatment or waiting-list control group. Eighteen people received a purely behavioral treatment for 8 sessions over a period of 8 weeks; 18 served as the wait-list control group. Before and after treatment, subjective, cognitive, and behavioral measures of anxiety were taken. Results showed that a purely behavioral treatment led to improvement in measures of behavioral, subjective, and cognitive anxiety. This research adds to the literature on cognitive or behavioral treatment of social phobia showing that cognitive restructuring can occur without specific cognitive treatment, and that interventions for phobia are not necessarily mode specific.