Further Outpatient Care

Referral to a psychiatrist or other mental health professional for diagnostic evaluation is indicated.

Referral to a clinician trained in behavioral or cognitive-behavioral therapy can be beneficial. Components of this type of therapy include education, social skills training, relaxation training, rewards for social behavior, slowly graduated exposure to feared situations, and helping the child correct distorted thoughts during feared encounters (real or simulated).

Group therapy may be effective.

Continue monitoring medication dose and adverse effects.

Encourage parents and patients to confront feared situations as tolerated. Supporting additional social interaction in activities in which someone feels competent (eg, sports, art, music) can increase the chance of success.

Watch for the emergence of other psychiatric conditions, particularly major depression and substance abuse.

Inpatient & Outpatient Medications

Although medications are not often used in cases of avoidant personality disorder without other comorbid conditions, improvement has been observed in patients with social phobia using SSRIs, SNRIs, benzodiazepines, MAOIs, and some anticonvulsants.

Avoid caffeine, which may trigger anxiety symptoms.

Deterrence/Prevention

Current studies are underway to assess the possibility of preventing social anxiety disorders in shy, inhibited children who do not yet meet the criteria for a psychiatric diagnosis.

Reducing parental overprotection and displays of parental anxiety may be beneficial in helping a child to manage his or her anxiety more effectively.

Complications

Complications may include the following:

Social phobia
Major depression
Substance abuse
Long-term difficulties in social and occupational functioning

Questions

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