A casework report of social anxiety disorder with anankastic personality disorder: a cognitive behaviour therapy approach

Co-morbidity of personality disorders is common with anxiety disorders; cognitive behaviour therapy (CBT) has shown some efficacy in treatment of such conditions. A 37-year-old male case of social anxiety disorder with anankastic personality disorder was referred to the psychiatric social worker by the unit consultant for psychosocial intervention inclusive of CBT. Twenty five sessions, each lasting around one hour, were conducted daily with the client on an inpatient basis to: (1) assess his problem, (2) grade the problem in a hierarchy, (3) expose him gradually to anxiety provoking situations, (4) teach cognitive behavioural techniques to ameliorate stress, (5) help him realise the safety behaviours used and to consciously cut down on them, (6) challenge and confront distortion, and (7) help him improve communication with his wife. At the time of discharge, the patient had improved nearly 30% and was more confident of facing social situations and interaction with people.