Cognitive Therapy and Desensitization Based Exposure for Social Anxiety Disorder: The Case of “Ayesha”

Social Anxiety Disorder (SAD) is a critical condition characterized by excessive fear and avoidance of social situations. Cognitive Therapy (CT) combined with Desensitization-Based Exposure (DBE) is a short-term, evidence-based intervention (8–20 sessions) for SAD involves techniques such as identifying and disputing negative automatic thoughts, reducing safety behaviors, reinforcing positive self-statements, and developing assertive communication skills. This study aims to provide a systematic account of a 12-session CT-DBE intervention for a 21-year-old female, referred to a pseudo name “Ayesha” to maintain confidentiality. Using a case study design, qualitative data were analyzed alongside standardized quantitative assessment measures, i.e., Mini-Mental Status Examination, Rorschach test for Personality profile, Liebowitz Social Anxiety Scale (LSAS-SR) for self-report measure of social anxiety as pre-test measures, and Subjective Unit of Distress Scale administered as pre-and post-treatment measure. The intervention followed a structured approach incorporating cognitive restructuring, graduated exposure, and behavioural modifications to address Ayesha’s social anxiety symptoms comprehensively. The findings indicate a significant reduction in Ayesha’s social anxiety symptoms, increased engagement in social interactions. Qualitative analysis in the Rorschach test further highlighted enhanced cognitive flexibility, reduced avoidance behaviours, and greater confidence in social contexts. These findings (based on pre-intervention assessment and pre-post SUDS-ratings) contribute to the growing evidence supporting CT-DBE as a reliable treatment specifically in the Pakistani context for individuals with SAD. Future research should explore long-term maintenance of treatment gains and adaptations for diverse populations globally.