Therapy for Social Anxiety Disorder (2023)

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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Therapy for Social Anxiety Disorder (1)

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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.

The Best Online Therapy ProgramsWe've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.

(Video) Treatment of Social Anxiety Disorder

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 experiencenegative 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 afear 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.

How Exposure Therapy for SAD Works

(Video) CBT for Social Anxiety Disorder: Using downward arrow and thought challenging techniques

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.

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.

  1. Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence. Dialogues Clin Neurosci. 2015;17(3):337-46. PMID:26487814

  2. U.S. National Library of Medicine. Cognitive Behavioral Therapy.

    (Video) Social Anxiety Disorder - causes, symptoms, diagnosis, treatment, pathology

  3. U.S. National Library of Medicine. Social anxiety disorder.

  4. Olthuis JV, Watt MC, Bailey K, Hayden JA, Stewart SH. Therapist-supported Internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Database Syst Rev. 2016 Mar 12;3:CD011565. doi:10.1002/14651858.CD011565.pub2

Additional Reading

Therapy for Social Anxiety Disorder (2)

By Arlin Cuncic
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety."

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(Video) Spotlight on Social Anxiety Disorder

FAQs

What type of therapy is best for social anxiety? ›

Cognitive behavioral therapy (CBT) is the most effective type of psychotherapy for anxiety, and it can be equally effective when conducted individually or in groups. In exposure-based CBT, you gradually work up to facing the situations you fear most.

How effective is therapy for social anxiety? ›

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.

Can you completely overcome social anxiety? ›

Social anxiety is very treatable, with strategies for overcoming social anxiety depending on your individual personality and how much the disorder affects your life.

Can I treat social anxiety by myself? ›

Talk with a therapist

Social anxiety is a mental health condition, and it's not always possible to work through symptoms yourself. You can do a lot on your own to manage the anxiety and distress you experience, but getting professional support is always a good place to start.

How many sessions does it take to treat social anxiety? ›

Previous studies have reported that long-term treatment of 14 or 16 sessions, once a week, was effective [16,28], while short-term treatment of eight sessions was also effective [13]. Our research team reported that eight intensive exposure sessions for 2 weeks were effective enough to reduce social anxiety [18].

What is the success rate of therapy for anxiety? ›

Fortunately, anxiety is a highly treatable condition. A study conducted by the National Institute of Mental Health found that over half of all patients who received therapy for anxiety, depression, and other mental health conditions experienced significant improvement in their symptoms.

How long does it take for therapy to work for social anxiety? ›

How Long Does it Take to Overcome Social Anxiety? Most people can make significant reductions in their degree of social anxiety in a few months, provided they do the assigned homework tasks. The average length of time needed for treatment to be effective ranges from 12 to 20 weeks.

How long does it take to cure anxiety with therapy? ›

A minimum of 24 sessions of CBT therapy may be needed to treat a presentation of severe anxiety. Some individuals may recover more quickly, while others may require 48 or more CBT sessions combined with additional therapies to ensure that underlying root causes of anxiety are tackled.

What is the fastest way to cure social anxiety? ›

Also, realize that sometimes people need to seek professional help to deal with their social anxiety.
  1. Control Your Breathing. ...
  2. Try Exercise or Progressive Muscle Relaxation. ...
  3. Prepare. ...
  4. Start Small. ...
  5. Take the Focus Off Yourself. ...
  6. Talk Back to Negative Thoughts. ...
  7. Use Your Senses.
28 Aug 2022

What is the root of social anxiety? ›

Negative experiences.

Children who experience teasing, bullying, rejection, ridicule or humiliation may be more prone to social anxiety disorder. In addition, other negative events in life, such as family conflict, trauma or abuse, may be associated with this disorder.

How I healed my anxiety without drugs? ›

Anxiety Treatment Without Medication: 7 Holistic Ways to Cope
  1. Keep Your Blood Sugar in Check. ...
  2. Avoid Stimulants. ...
  3. Get Enough Sleep. ...
  4. Just Breathe. ...
  5. Practice Mindfulness. ...
  6. Exercise. ...
  7. Do What You Enjoy. ...
  8. Where to Get Help.
6 Dec 2017

Is social anxiety a lifetime? ›

Following onset in adolescence, patients with generalized SAD often experience a lifelong and unremitting mental disorder characterized by severe anxiety and disability.

Is anxiety treatment lifelong? ›

The sensitivity to anxiety can be, for some people, a lifelong condition that requires careful management. But that's very different to saying that living in a state of anxiety their whole lives is inevitable. For one, although trait anxiety is very stable over time, it does decrease across the lifespan.

Is therapy better than medication for anxiety? ›

For anxiety disorders, cognitive-behavioral therapy, antidepressant medications and anti-anxiety medications have all been shown to be helpful. Research generally shows that psychotherapy is more effective than medications, and that adding medications does not significantly improve outcomes from psychotherapy alone.

Can anxiety go away with therapy? ›

Most people with anxiety disorders never fully eliminate their anxiety. However, they can learn how to control their feelings and greatly reduce the severity of their anxiety through therapy (and medication if needed).

When should you stop therapy? ›

There is no “right” length of time to be in therapy. But for most people, there will come a time when therapy no longer feels necessary or progress has stalled. In most cases, the client will choose to end therapy; there are also situations in which a therapist decides to end sessions and refer a client elsewhere.

Is therapy once a month enough? ›

If that's not possible, many therapists will advise no less than twice monthly sessions. Once-monthly therapy sessions tend to hinder a client's progress and prolong the length of time spent in therapy - it's simply not enough time and not often enough support to develop significant change.

How many therapy sessions do I need? ›

So how long does it typically take for treatment to work? Recent research indicates that on average 15 to 20 sessions are required for 50 percent of patients to recover as indicated by self-reported symptom measures.

Is one therapy session enough? ›

The single sessions worked especially well for decreasing anxiety and behavioral problems. In fact, Schleider says, on these measures, one session of therapy turned out to be about as effective as 16 sessions. “I don't know if that's great or scary,” she says.

How often should you see a therapist for anxiety? ›

Therapy has been found to be most productive when incorporated into a client's lifestyle for approximately 12-16 sessions, most typically delivered in once weekly sessions for 45 minutes each. For most folks that turns out to be about 3-4 months of once weekly sessions.

How do you know if therapy is working? ›

6 Progress-in-Therapy Indicators
  1. Your moods and emotions have improved. Depending on the reasons for entering therapy, check if any of your symptoms have improved. ...
  2. Your thinking has shifted. ...
  3. Your behaviors have changed. ...
  4. Your relationships with others are better. ...
  5. You have better life satisfaction. ...
  6. Your diagnosis changes.
24 Jan 2017

Is social anxiety born or made? ›

There is a wealth of research and expert testimony that show people often develop social anxiety as a result of traumatic experiences and environments fraught with anxiety. They usually develop the social anxiety during childhood or teen years.

What is severe social anxiety? ›

Social anxiety disorder is an intense, persistent fear of being watched and judged by others. This fear can affect work, school, and other daily activities. It can even make it hard to make and keep friends. The good news is social anxiety disorder is treatable.

Why is social anxiety disorder so common? ›

Often when people have been bullied during childhood and adolescence, they grow up with fears of social situations. They learn from past experiences that social activities often lead to bullying, humiliation, and teasing. Their self-worth and self-confidence are impinged by negative interactions with others.

What vitamin helps with anxiety? ›

B-complex, vitamin E, vitamin C, GABA, and 5-HTP are 5 vitamins commonly used to help with anxiety and stress.

How does vitamin D help anxiety? ›

The study found that taking vitamin D supplements significantly decreased anxiety levels in women suffering from type 2 diabetes. Another study found that those suffering from anxiety had lower levels of calcidiol. Broken down vitamin D produces the byproduct, calcidiol.

How I cured my anxiety disorder permanently? ›

Here are eight simple and effective ways to battle anxiety without medication.
  1. Shout it out. Talking to a trusted friend is one way to cope with anxiety. ...
  2. Get moving. ...
  3. Break up with caffeine. ...
  4. Give yourself a bedtime. ...
  5. Feel OK saying no. ...
  6. Don't skip meals. ...
  7. Give yourself an exit strategy. ...
  8. Live in the moment.

Why is CBT The best treatment for social anxiety? ›

Through CBT for social anxiety, people learn different ways of reacting to thoughts and feelings, and they learn to engage in different behaviors that result in decreased fear. CBT also helps people learn and practice social skills when there is a deficit.

What therapy approach is best for anxiety? ›

Cognitive behavioral therapy (CBT) is the most widely-used therapy for anxiety disorders. Research has shown it to be effective in the treatment of panic disorder, phobias, social anxiety disorder, and generalized anxiety disorder, among many other conditions.

What is the first line treatment for social anxiety disorder? ›

SNRIs: Venlafaxine is an SNRI approved for first-line treatment of SAD. SNRIs work similarly to SSRIs; however, with SNRIs, concentrations of both serotonin and norepinephrine are increased. In studies, venlafaxine was superior to placebo in reducing total SAD symptom severity.

How long does therapy last for social anxiety? ›

CBT for social anxiety usually consists of weekly, one-hour sessions, and usually lasts between four to six months. Connect with a therapist trained in CBT that specializes in treating social anxiety.

How do psychologists treat social anxiety? ›

Psychotherapy. Cognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat social anxiety disorder. CBT teaches you different ways of thinking, behaving, and reacting to situations to help you feel less anxious and fearful.

What is the success rate of CBT for anxiety? ›

Research shows that CBT is the most effective form of treatment for those coping with depression and anxiety. CBT alone is 50-75% effective for overcoming depression and anxiety after 5 – 15 modules. Medication alone is effective, however, science still does not understand the long-term effects on the brain and body.

How long does it take to cure anxiety with therapy? ›

A minimum of 24 sessions of CBT therapy may be needed to treat a presentation of severe anxiety. Some individuals may recover more quickly, while others may require 48 or more CBT sessions combined with additional therapies to ensure that underlying root causes of anxiety are tackled.

What are 4 suggestions for treating anxiety? ›

Some ways to manage anxiety disorders include learning about anxiety, mindfulness, relaxation techniques, correct breathing techniques, dietary adjustments, exercise, learning to be assertive, building self-esteem, cognitive therapy, exposure therapy, structured problem solving, medication and support groups.

How long does therapy take for anxiety? ›

The number of recommended sessions varies by condition and treatment type, however, the majority of psychotherapy clients report feeling better after 3 months; those with depression and anxiety experience significant improvement after short and longer time frames, 1-2 months & 3-4.

What is the root of social anxiety? ›

Negative experiences.

Children who experience teasing, bullying, rejection, ridicule or humiliation may be more prone to social anxiety disorder. In addition, other negative events in life, such as family conflict, trauma or abuse, may be associated with this disorder.

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