Treating Social Anxiety in an Era of Social Distancing: Adapting Exposure Therapy for Youth During COVID-19

• Published in: Cognitive and behavioral practice Vol. 28; no. 4; pp. 669 - 678
• Main Authors: Khan, Anika N., Bilek, Emily, Tomlinson, Rachel C., Becker-Haimes, Emily M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.11.2021; Association for Behavioral and Cognitive Therapies. Published by Elsevier Ltd
• Subjects: COVID-19; exposure; social anxiety; telehealth; youth; COVID-19; exposure; telehealth; social anxiety; youth
• ISSN: 1077-7229; 1878-187X; 1077-7229
• DOI: 10.1016/j.cbpra.2020.12.002

•The COVID-19 pandemic may uniquely impact youth with social anxiety disorder.•Continuing exposure therapy to treat social anxiety symptoms in youth is critical.•Considerations for treating socially anxious youth during COVID-19 are discussed.•Exposure therapy can be successfully adapted to adhere to public health guidelines.•Modifications for exposure therapy and considerations for the future are presented. The novel coronavirus (COVID-19) pandemic has caused widespread disruption to our traditional way of life and mental health therapy has not been spared. A combination of increased anxiety, diminished social opportunities, and the shift to telehealth service provision presents particular challenges for the treatment of social anxiety in youth, which relies heavily on exposures to social situations with peers, adults, or other feared social stimuli. The objective of this commentary is to provide guidance to clinicians working with youth with social anxiety on how to maintain ethical, evidence-informed provision of exposure therapy in light of these unusual circumstances. We first present an overview of how COVID-19 may uniquely impact youth with social anxiety and highlight the importance of continuing to provide exposure-based treatments during this time. We then discuss guiding principles for delivering exposure therapy during COVID-19. We focus on providing practical examples of how common social anxiety exposures can be adapted and delivered successfully through telehealth while abiding by COVID-19 social distancing guidelines. Finally, we discuss key recommendations to assist clinicians in moving treatment forward while considering changing safety guidelines pertaining to COVID-19.