Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: One of the most important anxiety disorders that disrupt people's lives is social anxiety disorder. This anxiety is caused by concerns related to negative evaluation and fear of adverse reactions from others, an expectation of failure in socialization, or rejection of their weakened social skills. One of these psychological variables that may be affected by social anxiety in people, especially in teenage students, is social skills. Adolescents with social anxiety are at risk of social immaturity and social dysfunction. Various research studies have proven the effectiveness of treatment protocols such as endurance exercises, metacognitive therapy, and solution-oriented therapy in improving social skills. However, in the review of the effectiveness of the mentioned treatment protocols, no study examined the differences between these treatments. So, the purpose of this study was to investigate the efficacy of metacognitive therapy, solution-focused therapy, and endurance exercises on the social skills of female students with social anxiety disorder.
Methods: The current research method was quasi-experimental with a pretest-posttest and a one-month follow-up design with a control group. The statistical population included all female students of the second high school level in the three educational districts of Kermanshah City, Iran, in the academic year 2022-2023. From this population, 60 students were selected according to the inclusion criteria and were randomly assigned to 4 groups of 15 students each (three experimental and one control). The inclusion criteria were personal satisfaction with attending training sessions, diagnosis of social anxiety disorder (getting a score of 19 and above on the social anxiety questionnaire), not having a medical history related to social anxiety, and not suffering from other psychological disorders. The exclusion criteria were the use of psychiatric and psychoactive drugs, the absence of more than two sessions, and participation in other courses and therapeutic interventions at the same time as the present study. The therapeutic interventions of endurance exercises, metacognitive therapy, and solution-focused therapy were applied to the experimental groups. The control group remained waiting (the group awaiting treatment), and no intervention was used. To collect information, the Social Phobia Inventory (SPIN) (Konnor et al., 2000) and the Teenage Inventory of Social Skills (TISS) (Inderbitzen & Foster, 1992) were used. Data analysis was done in SPSS 23 software with the analysis of variance with repeated measurements and Bonferroni's post hoc test at a significance level of 0.05.
Results: The findings showed that, in the posttest and follow-up stages, all three treatments increased appropriate social behavior and decreased inappropriate social behavior of female students with social anxiety disorder (p<0.001). Also, among the three treatments, the solution-focused treatment was more effective in the posttest of the appropriate social behavior variable than the endurance exercises (p<0.001). In the posttest of the inappropriate social behavior variable, the solution-focused treatment compared to endurance exercises (p=0.021), and in the follow-up of the inappropriate social behavior variable, metacognitive therapy (p=0.008) and solution-focused treatment (p<0.001) compared to the endurance exercises was more effective.
Conclusion: The results showed that all three treatment models can be used in the Iranian clinical sample. However, solution-focused treatment is more effective in appropriate social behavior than endurance exercises. In addition, this treatment is more effective in inappropriate social behavior than two metacognitive treatments and endurance exercises.