Does Cognitive Behavior Therapy Change Socially Anxious Adolescents' Behavior during a Public Speaking Task?

Public speaking is one of the most commonly feared situations by socially anxious adolescents, often prompting behavioral anxiety markers including gaze avoidance and speech disruptions. While the potential adverse social consequences of behavioral anxiety markers in public speaking contexts have been established, research into how these markers might alter through cognitive behavior therapy is still in its infancy. In this preliminary study, we investigated changes in gaze behavior and speech disruptions from before to after 12 weeks of disorder-specific group cognitive behavior therapy among 41 adolescents aged 11-17 years (M = 14.46, 48.78% girls) with social anxiety disorder. Participants spoke for five minutes in front of a pre-recorded classroom audience while wearing an eye-tracker, before and after the Skills for Academic and Social Success program. Following treatment, we found an increase in frequency of gaze towards the faces of the audience while speaking, with greater changes among older participants. There were no changes in speech disruptions at the group level. We conclude that therapy may have a positive effect on gaze behavior, and discuss the clinical implications and opportunities for future research in this emerging field of study.