Therapy for Social Anxiety Disorder

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Social anxiety disorder (SAD) is commonly treated with cognitive behavioral therapy (CBT), a form of therapy that was pioneered in the 1960s for the treatment of depression. It is now a leading treatment for many conditions, including anxiety disorders. Research has shown that CBT is an effective therapy for social anxiety disorder.

CBT uses a combination of techniques that may vary depending on the disorder being treated. For example, CBT for depression will be different from CBT for SAD or other anxiety disorders. Because there are so many different techniques, it is important to look for a therapist that has experience with the techniques that are most effective for treating SAD.

This article discusses the goals of CBT as a therapy for social anxiety disorder. It also covers some of the techniques and methods that may be used in this type of treatment.

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Goals of CBT for Social Anxiety Disorder

One of the central goals of CBT is to identify irrational beliefs and thought patterns and replace them with more realistic ones. Your thoughts, emotions, and behaviors are all linked. By identifying unhelpful thoughts, you can then change the way you feel and behave.

As part of the therapy process, you will work on a number of problem areas including:

  • Negative beliefs you may have about your abilities and self-worth
  • Guilt, embarrassment, or anger over past situations
  • How to be more assertive
  • Tackling perfectionism and being more realistic
  • Dealing with procrastination related to social anxiety
  • Mistaken beliefs that others are judging you

Your CBT therapy sessions may feel somewhat like a student-teacher relationship. The therapist will take the role of a teacher, outlining concepts and helping you on a path of self-discovery and change. You will also be given homework assignments that are key to making progress.

Keys for Success

There are a number of things that can help make CBT more successful in the treatment of social anxiety disorder.

The likelihood that CBT will help you depends largely on your expectations about success, your willingness to complete homework assignments, and your ability to confront uncomfortable thoughts.

People who are willing to work hard and believe that CBT will help them are more likely to improve. Although this form of therapy is intensive and requires active participation by the person with SAD, it is effective and the improvements are long-lasting.

Cognitive Techniques

CBT focuses on changing the problematic thinking that contributes to anxiety. Cognitive methods can help you learn to feel less anxious and more in control in social situations.

People with SAD experience negative thoughts that occur automatically and are out of step with reality. These thoughts increase anxiety and lessen your ability to cope.

For example, if you have a fear of public speaking, just thinking about the situation will elicit thoughts of embarrassment and fear of failure. The goal of CBT is to replace these cognitive distortions with more realistic views.

If you have SAD, you have probably had someone tell you to just "think positive." Unfortunately, the problem is not that simple to solve; if it were, you likely would have overcome your anxiety long ago.

Because your brain has become hardwired to think negatively, it needs to be gradually trained to think in a new way. Just telling yourself "I will be less anxious next time" doesn’t work, given your current way of thinking.

Learning to change these thoughts can help you feel less anxious in social situations. Changing negative automatic thinking in the long term requires practice and repetition until it eventually becomes automatic and habitual.

Over time, your memory processes and neural pathways in your brain will change. You will begin to think, act, and feel differently.

Recap

The ultimate goal of cognitive therapy is to change your underlying core beliefs that influence how you interpret your environment. A change in your core beliefs will lead to long-lasting improvement of your anxiety symptoms.

Behavioral Techniques

Another element of CBT that focuses on changing socially anxious behaviors is known as systematic desensitization. This is a type of exposure training that involves learning to relax as you are gradually exposured to anxiety-provoking situations. Over time, you begin to feel less fearful of these situations.

Exposure training for SAD has to be a very gradual process. People may have told you to "toughen up and face your fears;" unfortunately, this is extremely bad advice. People with social anxiety are already forced to face what they fear on a daily basis.

With your therapist, you will gradually expose yourself to feared situations so that over time they no longer elicit fear. At first, you may practice imagined exposure, such as imagining giving a speech or practicing a job interview through role-playing.

Once the practiced or imagined situation becomes easier, you would move to the situation in the real world. Exposure that is not structured in a gradual step-by-step process does more damage than good. It will make your anxiety worse, keep you locked in a vicious cycle, and can lead to doubt and depression.

Recap

Exposure therapy can be an effective way to change behaviors associated with social anxiety, but it needs to be done carefully and gradually. Forcing yourself into frightening situations without preparation and support may actually make your anxiety worse.

Internet CBT for SAD

Cognitive behavioral therapy can also be provided over the Internet (i-CBT). This type of CBT is becoming increasingly common and has some research evidence to support its use. It can be particularly effective when it is supported by a mental health professional.

Because CBT follows a structured format, it is well-suited for online use in both self-help or therapist-supported interventions. This form of CBT may also be helpful for those with severe social anxiety who are not yet at the point of being able to leave home to attend in-person therapy appointments.

Summary

Cognitive behavioral therapy is one of the most effective types of therapy for social anxiety disorder. This treatment can be used to change the negative thoughts that contribute to anxiety, help you learn new coping strategies, and gradually decrease the fear you experience in social situations.

A Word From Verywell

If you live with social anxiety that impairs your day-to-day functioning, it is important to seek help from your doctor or mental health professional. If you are diagnosed with social anxiety disorder, an effective treatment plan including CBT can help you to overcome symptoms and manage your social anxiety.

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4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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