The treatment of social phobia in general practice. Is exposure therapy feasible?

Background. Exposure therapy is an effective treatment for generalized social phobia. Most patients with social phobia are treated in primary care, but family doctors are not usually trained to perform exposure therapy. We have conducted a study in primary care of the effect of exposure therapy alone or in combination with sertraline on generalized social phobia. Objectives. The purpose of this article is to describe the training of GPs and the application of the treatment programme in general practice. Method. Forty-five GPs were trained for ~30 h in assessing patients with social phobia and conducting exposure therapy. The training programme included scoring of videotaped interviews of five patients on several social phobia scales, and a videotape demonstrating different steps of an exposure therapy was used as a model for role play in group training. Results. All of the GPs completed the training programme. The doctors expressed satisfaction with the programme and also found it useful in the treatment of patients with conditions other than social phobia. There was a significant difference in response between the treatment groups (P = 0.001), and the combination of exposure therapy and sertraline seemed to be particularly beneficial.