Interest in culturally specific factors in social anxiety disorder (SAD) arose from its integration into the nosology of psychopathology. We took up this question in the treatment of SAD with an immigrant patient. Taking into consideration that issues related to immigration can enhance vulnerability to SAD, we developed a cognitive-behavioral therapy that addressed the cultural elements involved in the emergence of SAD with this patient. In this case study, the therapeutic elements characteristic of the patient's situation are analyzed in light of current research conducted on SAD. Loubna, aged 16 and Algerian born, developed a SAD upon her arrival in France. The loss of her parental figures and her protective family environment precipitated the onset of symptoms. Bögels et al. (2001) [3] have specifically studied parenting behaviors that enhance the emergence of SAD. They have highlighted the need for a specific therapeutic action, which includes the whole family in the treatment of SAD in children and adolescents. We described these parental attitudes and the ways of therapeutic action. In this case, we also looked at the link between shyness and social anxiety. Chavira et al. (2002) [4] described shyness as a risk factor for the onset of SAD. Even though early signs of shyness can be identified in Loubna's childhood, she only developed this disorder in her adolescence. We tried to observe this transition in relation to literature analyzing this link. After a description of the therapeutic process established for Loubna, we focused our attention on the behavioral work carried out on the reduction of avoidances (avoidances of social experiences and gaze avoidance). Indeed, Horley et al. (2003) [15] identified that patients with social anxiety tend to avoid facial signals during their social interactions. The therapeutic process was designed to reduce this tendency in Loubna's case. On the other hand, Hoffman (2004) [16] showed that therapeutic intervention based on cognitive biases interpretation of patients with social phobia is more effective in maintaining long-term therapeutic benefits than therapy treatment based only on exposure. Therefore, we correlated the increase of social experiences with the cognitive work focusing on raising positive cognitions in social situations. The therapeutic process is described as well as the evolution of Loubna's cognitions. At the end of the cognitive and behavioral therapy, the benefits were evaluated. In addition to a significant reduction in phobic symptoms, measurements throughout therapy showed positive changes in social cognition. Loubna's attention was more focused on detection of emotion on other people's faces. The focus of this therapy was the inclusion of culturally specific factors. Shore and Rapport (1998) [26] found different levels of social anxiety across cultures, with a range of variable social fears. Throughout the cognitive-behavioral therapy, we analyzed these cultural elements, which facilitated and weakened Loubna's treatment. After 8 months of therapy, Loubna's SAD went from severe to moderate and the patient was able to join a training course. Her interpersonal skills improved and she succeeded in expanding her social network. This therapy has emphasized the complementary nature of cognitive and behavioral approaches to achieve a significant reduction in SAD symptoms. The behavioral work helped reduce fear of others through exposure, and the cognitive restructuring work led to the emergence of protective schemas in interactive situations. This case study also illustrates the need to take into account the combination of individual, family, social and cultural factors in the analysis and treatment of children and adolescents with SAD.