Sara, A Social Phobia Client with Sudden Change After Exposure Exercises in Intensive Cognitive-Behavior Group Therapy: A Case-Based Analysis of Mechanisms of Change

Abstract

This case study deals with Sara, a 37-year-old social phobic woman who suffered from a primary fear of blushing as well as comorbid disorders, including obsessive-compulsive disorder, generalized anxiety disorder and spider phobia. The client was treated in an intensive, one-week group cognitive-behavioral therapy program in an educational university clinic in Aarhus, Denmark. She achieved a remarkable and durable change in her longstanding social phobia after two in-session behavioral experiments conducted during the third and fourth days of the program. After treatment, the client was interviewed about her sudden gain, and she read and commented on the case study report. The primary aim of the study was to investigate the micro-level mechanisms of change for this particular client, and thereby illustrate the prospects of pragmatic case studies in meticulous process research focusing on one of the most intricate problems in psychotherapy: how does treatment work.