How Cognitive Behavioral Therapy Can Help Social Anxiety

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A sad looking person sits alone at an outdoor table.

 

Social anxiety affects about 15 million U.S. adults, leaving them with obsessive, often debilitating fears about being judged or rejected, according to the Anxiety and Depression Association of America. People who have social anxiety dread appearing anxious or being perceived as stupid, awkward or boring. Fortunately, cognitive behavioral therapy (CBT) for social anxiety can help.

Social anxiety is more than shyness or introversion. It can cause people to experience such distress that they tremble or perspire. Social anxiety can significantly impair individuals’ quality of life, leading them to turn down career opportunities, avoid pursuing higher education or stop making new friends.

When people undergo CBT for social anxiety, they learn how to alter the thoughts and behaviors that lead to their anxiety, eventually gaining more control over their interactions with others. CBT can help individuals think, act and feel in new ways that can improve their lives.

For anyone who has an interest in working as a therapist and offering treatments such as CBT for social anxiety, pursuing an online Bachelor of Arts in Psychology is a good way to embark on a rewarding career.

How CBT Works

CBT helps people change their harmful emotional responses to events. During CBT, individuals work toward goals such as:

  • Replacing irrational, distorted thoughts with realistic ones
  • Changing underlying beliefs that affect how they view their environments
  • Learning coping strategies to better manage specific situations

This form of treatment typically involves a few basic steps, starting with identifying the problem.

Identify Troubling Conditions or Situations

Therapists and their clients first discuss the issues that are troubling to clients and determine the specific problems that CBT will address. For example, clients may experience intense worry about inviting a friend for coffee, asking someone on a date, or asking a question during a class or work meeting.

Become Aware of Thoughts, Emotions and Beliefs

In discussing a client’s thoughts, emotions and beliefs about a troubling social situation, the therapist and client work together to uncover how the client interprets the situations and the client’s beliefs about them. For instance, a person may believe that a friend who ignores their greeting no longer likes them, when another interpretation of the event could be that the friend wasn’t aware of the greeting because they were preoccupied when they received it.

Identify Negative or Incorrect Thinking

Therapists and their clients work together to pinpoint negative or inaccurate thoughts. Examples of negative thinking include:

  • Assuming they know what others think
  • Personalizing others’ general comments
  • Expecting the worst from a situation

Challenge and Alter Negative or Incorrect Thinking

Focusing on specific incidents, therapists and clients talk about the clients’ inaccurate or unrealistic thoughts. Together, they work on replacing those assumptions with accurate, realistic interpretations.

Develop Coping Strategies and Skills              

Ultimately, CBT leads to establishing concrete actions for clients to take to develop healthy thinking and behaviors.

To support the CBT’s effectiveness, clients should practice replacing their negative thoughts with realistic ones on a regular basis. Practicing realistic thinking consistently allows the process to become second nature over time.

Clients typically complete CBT over the course of 12 to 20 weeks, with sessions lasting 30 to 60 minutes each.

How CBT Can Alleviate Social Anxiety

More than 75% of people with social anxiety experience symptoms during childhood or as teenagers. Without treatment, social anxiety can skew the trajectory of a person’s life. However, when individuals initiate CBT to relieve social anxiety, they can lift limitations that their social anxiety places on their lives.

For instance, social anxiety can trigger physical symptoms such as rapid heart rate or nausea, which can disrupt daily life. Furthermore, experiencing social anxiety can increase an individual’s risk of developing major depressive or alcohol use disorders.

Therapists who use CBT to treat social anxiety employ strategies that include the following.

Experimentation               

During CBT, clients and their therapists can experiment with role-playing various social situations, such as making conversation with someone new, as well as practice new coping strategies, such as controlled breathing. Therapists can also create experiments for clients to try outside their therapy sessions, such as approaching a stranger to ask for directions to practice the skills they learn.

Written Guidelines

Individuals who experience social anxiety can benefit from specific tools developed to pinpoint negative emotions and thoughts such as embarrassment or self-blame.

As an example, the Social Anxiety Association suggests giving people with social anxiety guidelines in the form of handouts. Individuals with social anxiety can refer to these written guidelines for specific explanations about how to address their negative thinking and gradually replace it with realistic thinking.

Thought Records

Keeping a “thought record” helps individuals identify their negative thoughts. This allows an individual to pay attention to their thoughts triggered by actual events, explore their feelings about those events and work toward changing their interpretation of them.

A typical thought record entry includes a description of an event, such as receiving an invitation to give a presentation at work. Next, the client writes down their negative thoughts and feelings about the event, such as fear of ridicule. The client then responds to challenge questions, such as “Is there another way I can interpret this event?”

Preparing for Specific Situations               

Through CBT, therapists and their clients can develop specific strategies for how to cope in situations that trigger social anxiety, such as talking with new people or attending a gathering. Having a strategy in place enables the client to feel more confident in their ability to handle social situations.

How People with Social Anxiety Can Access CBT

As technology and approaches to therapy advance, more pathways for accessing CBT for social anxiety have become available, so individuals have several options for getting the help they need.

They can undergo CBT treatment with therapists in traditional, in-person therapy sessions. Individuals also can attend group or family CBT therapy sessions. If they have difficulty leaving their homes, individuals can obtain CBT over the telephone, via the internet or through video telepsychotherapy.

A variety of therapists — psychologists, clinical social workers, and mental health and behavioral counselors — offer CBT, and the role the therapist plays in CBT is critical. The National Association of Cognitive-Behavioral Therapists notes that a CBT therapist’s role is to listen, teach and encourage the client in an environment in which the therapist and client work together toward the same goal. Therapists determine the pace at which CBT proceeds and the specific strategies to use.

Exploring Opportunities to Address Social Anxiety Through CBT

Experiencing social anxiety can be debilitating. With an appropriately trained therapist, CBT offers people the opportunity to chart a new course.

If becoming a therapist and offering treatment such as CBT for social anxiety sounds appealing, then exploring Rider University’s online Bachelor of Arts in Psychology program could be the first step. Discover the potential for a gratifying career as a therapist.

 

Recommended Readings

Anxiety in Teens: Statistics, Hotlines and Resources for Improving Mental Health

How to Become a Mental Health Counselor

Types of Social Influences and Their Effect on Behavior

 

Sources:

Anxiety and Depression Society of America, Social Anxiety Disorder

Association for Behavioral and Cognitive Therapies, Cognitive Behavioral Therapy

Association for Behavioral and Cognitive Therapies, Shyness, Social Anxiety Disorder, and Social Phobia

Association for Behavioral and Cognitive Therapies, What Is Cognitive-Behavior Therapy

Harvard Business Review, “Digital Tools Are Revolutionizing Mental Health Care in the U.S.”

Harvard Health Publishing, “Intensive CBT: How Fast Can I Get Better?”

Healthline, “9 CBT Techniques for Better Mental Health”

Mayo Clinic, Cognitive Behavioral Therapy

National Social Anxiety Center, CBT Strategies to Overcome Social Anxiety

Positive Psychology, “Thought Records in CBT: 7 Examples and Templates”

Psychology Today, “3 Steps to Treat Your Anxiety Using CBT”

Social Anxiety Association, Comprehensive Cognitive-Behavioral Therapy

Verywell Mind, “Cognitive-Behavioral Therapy for Social Anxiety Disorder”