What is an evidence-based approach for treating moderate to severe Social Anxiety Disorder?

• A. Cognitive-behavioral therapy with exposure only.
• B. Cognitive-behavioral therapy with exposure plus pharmacotherapy (SSRI/SNRI).
• C. Pharmacotherapy alone.
• D. Psychodynamic therapy.

Answer: (B)

Combining a structured cognitive-behavioral program that includes exposure with an SSRI or SNRI is the most consistently supported approach for moderate to severe Social Anxiety Disorder. Cognitive-behavioral therapy helps you identify and challenge distorted social fears and gradually face feared situations in a safe, controlled way, which reduces avoidance and improves daily functioning. The exposure component is central because it directly tests feared outcomes, providing corrective experiences that weaken the fear response over time. Medications like SSRIs and SNRIs address the underlying anxiety physiology, often bringing faster symptom relief and helping you engage more effectively in therapy. When used together, many people experience greater overall improvement, quicker relief, and better long-term maintenance than either approach alone, especially in more severe cases. Pharmacotherapy alone can ease symptoms but misses the skill-building from CBT, while CBT without meds may be less effective for very severe symptoms; psychodynamic therapy, while useful for some, has less robust evidence for treating Social Anxiety Disorder.