Studies of psychological treatments for comorbid SAD and alcohol use disorders suggest that the treatment of both disorders concurrently is no more beneficial than treatments focused on drinking alone [723], and that concurrent treatment may even have a deleterious effect on drinking outcomes [726].Research by Schadé and colleagues [723, 724] indicated that adding CBT and an optional SSRI to relapse prevention treatment for alcohol dependence yielded superior results for symptoms of anxiety in people with SAD, but did not improve drinking outcomes relative to alcohol relapse prevention treatment alone. Another study examined the efficacy of CBT for SAD and alcohol dependence compared with CBT for alcohol dependence only [726]. The authors found overall improvements in anxiety symptoms with no significant advantage of the additional CBT treatment, but poorer outcomes for the combined treatment group in regards to alcohol use. It should be noted, however, that neither of these studies examined integrated treatments for SAD and substance use, but treatment administered within a parallel model.
Recently, an integrated treatment has been developed for social anxiety and alcohol use disorders, which combines CBT and MI [727]. Preliminary findings indicate that it may be a promising approach for the treatment of comorbid SAD and alcohol use disorders [728]. Compared to participants randomly allocated to receive CBT for alcohol alone, participants receiving integrated CBT had better outcomes for symptoms of social anxiety, general functioning, and quality of life [729]. Both groups reduced their alcohol use, with no difference between groups.