The Shyness & Social Anxiety Workbook
78Given all of the different available options, it can be very difﬁcult for a consumer to 
select the best approach for overcoming a particular problem.
For most of the methods listed previously, there is almost no controlled research 
examining their use in treating anxiety in general and social anxiety in particular. The 
term controlled  is used to describe studies in which the investigators have examined the 
effects of a particular treatment while taking steps to ensure that any improvements that 
occur are, in fact, due to the treatment, rather than to other factors. Note that a lack 
of controlled research does not mean that a particular treatment is ineffective. It simply 
means we just don’t know whether the treatment works or how well it works.
Even if someone seems to improve after using one of these methods, it can be dif -
ﬁcult to know whether it was the treatment that had a beneﬁcial effect or whether other 
factors contributed to the change. For example, as we mentioned earlier, someone’s 
expectations of improving during treatment can affect his or her improvement. Other 
reasons why people might improve with a particular treatment may include the passage 
of time. For some types of problems (such as depression), the symptoms may improve 
naturally over time, regardless of whether the sufferer receives any speciﬁc treatments. 
Changes in a person’s normal routines (for instance, a reduction of stress at work) also 
can contribute to improvements over and above any treatment effects.
Properly controlled research can help to determine whether the effects of a treat -
ment are indeed due to the treatment rather than to other factors. One strategy used by 
researchers is the inclusion of a control group. For example, research studies that examine