If “epidemiological” studies are to be believed, estimated rates of prevalence of social phobia at the present are generally lower than those over the “lifetime.” Natural social processes (e.g. meeting an enterprising admirer, a sympathetic but demanding teacher) leading to remission would account for the difference. Little evidence of such benign processes can be seen however in the lives of patients seeking help, perhaps because these are for the most part little capable of taking advantage of naturally occurring social opportunities. Social phobia typically crystallizes as a pattern in the face of the increasingly insistent social and interpersonal demands of adulthood made on adolescents, and remains among the most chronic problems seen in the clinic (see chapter 5). Help is often sought long after the onset of problems. What of proven value can be offered such patients?

An attempt at the valuation of treatments of social phobia requires establishing boundaries as to what claims to consider and which to dismiss outright or ignore. What are the possibilities? One end of a continuum of strictness might be defined as an indulgent approach relying on the self-valuation of the proponents of various treatments. The other end might be designated as a discerning approach demanding relatively high quality of evidence. Immoderately, I shall opt for the latter for it seems to me that the most meaningful answer will arise from the careful selection of the best available studies, methodologically speaking.