Exposure Therapy for Social Anxiety

Anxiety Disorder
Read Time: 6 Minutes
Written by:Dr. Karmen Smith, LCSW, DD

Published On: September 22, 2023

Medically reviewed by: Bisma Anwar, MA, MSc, LMHC

Reviewed On: September 28, 2023

Updated On: September 28, 2023

Overview

Exposure therapy is one of the different types of therapy that can be successful in treating many phobia-based mental health conditions. Exposure therapy for social anxiety is an evidence-based approach that helps those who struggle with the overwhelming fear and distress they experience in social settings. It can help them feel safe and confident when navigating certain social situations, like public speaking or meeting new people.

Social anxiety, or social anxiety disorder, is characterized by an intense fear of being judged, humiliated, or embarrassed in social environments. It can also interfere with your life and ability to establish rewarding, deep, meaningful relationships. People with social anxiety disorder often use a coping technique known as avoidance, which is exactly what it sounds like — avoiding something instead of interacting with it.

Exposure therapy helps by exposing you to your fear in a safe environment and then gradually increasing the level of exposure to more challenging situations. The idea is to build self-confidence before moving on to more intense scenarios.

Learn more about how social anxiety exposure therapy can improve symptoms as you tackle your fear and regain control of your life. There’s no cure for social anxiety, but you can learn coping tools to manage it — and exposure therapy might be key to it all.

Is Exposure Therapy Good for Social Anxiety?

Studies show that exposure therapy — a type of cognitive behavioral therapy — can be an effective way to treat social anxiety for some people. It involves gradually exposing a patient to an anxiety provoking situation or feared stimulus in a safe and controlled manner to help them reduce their social phobia and anxiety.

How Does Exposure Therapy Work for Social Anxiety?

Social anxiety exposure therapy treats social anxiety disorder and other types of social anxiety by challenging the cycle of fear and avoidance you associate with social environments. Exposure therapy helps you learn to manage your emotions in a variety of triggering situations and reduce social anxiety symptoms.

In short, exposure therapy can help rewire your brain’s response to fear-inducing stimuli.

When using social anxiety exposure therapy, an experienced therapist will help you identify and set goals, create a hierarchy of fear-inducing situations, and then slowly expose you to your fears in a safe environment so you can build resilience and confidence.

Role-playing scenarios, public speaking practice, and slow exposure to parties or group outings are examples of how exposure therapy can help reduce symptoms of social anxiety.

The process of exposure therapy for social anxiety

Through exposure therapy, you can learn how to overcome social anxiety effectively. Here’s the typical step-by-step process of this type of therapy:

  1. Evaluation: Assess your fears and anxieties related to social situations.
  2. Set clear goals: Identify objectives that focus on overcoming your particular social fears.
  3. List hierarchy of fears: Rank social scenarios from least to most anxiety-provoking to guide exposure.
  4. Implement gradual exposure: You can practice facing triggers in real-life experiences or use imagined exercises guided by a therapist.
  5. Learn additional anxiety management techniques: Learn various coping strategies, such as deep breathing or mindfulness techniques, to manage anxious feelings during each feared social situation.
  6. Focus on mastery and progression: Continue practicing until you feel more comfortable in each scenario before moving on to more difficult ones.
  7. Evaluate progress: Monitor changes and adjust therapy accordingly.

To sum up the process, the most critical components of exposure therapy for social anxiety include the following:

  • Setting specific goals — Set clear goals tailored to your unique challenges so you can develop the skills you need to navigate social contexts successfully.
  • Creating a hierarchy of fear-inducing scenarios — Develop a hierarchy that lists anxiety-inducing situations from least to most challenging so you can face your fears and gradually build confidence and resilience.
  • Overcoming through practice and persistence — Exposure therapy for social anxiety can equip you with skills to manage your emotions and face the social settings that trigger you the most.

iconExpert Insight

“It is amazing how much of a role our fears play in our lives. Fears influence our decisions, work environment, family dynamics, and daily routines. Most of our fears are unconscious, meaning we are unaware of them. In therapy, those fears can be named, discussed, and experienced with support and clarity.”
Licensed Clinical Social Worker (LCSW), DD Karmen Smith

Examples of Exposure Therapy for Social Anxiety

Social anxiety exposure therapy ideas will be based on which type of social phobia you’re dealing with.

Fear of social situations

Addressing a fear of social settings is one of the more obvious ways exposure therapy can help manage social anxiety symptoms.

The build-up is simple — you start with small, basic social settings and slowly build up to bigger events.

iconExpert Insight

“Usually, both therapist and client agree that the goal is to overcome the phobia or anxiety around social interactions. The 1st activity may be small to accomplish the goal gradually and have victories along the way. For example, if the goal is to attend a large networking party, a starting point could be to engage a barista, where you get coffee every day in exchange. This could be a small victory heading to the larger goal.”
Licensed Clinical Social Worker (LCSW), DD Karmen Smith

Public speaking fears

Exposure therapy can be an excellent way to conquer a fear of public speaking. Today, some therapists even implement virtual reality exposure therapy (VRET) as part of therapy. While more research is needed, one study found that using VR exposure therapy to treat public speaking fears drastically reduced anxiety after just a 3-hour session. The results were still evident in participants 3 months post-study.

You can also practice speaking alone and slowly progress to giving speeches to small groups until you’re ready to present to larger audiences.

Eating fears

For some people with social anxiety, eating in public can be a terrifying thought. To use social exposure therapy to address this fear, you start small, eating in front of one person, and slowly build up to larger-scale scenarios where you’re eating in front of many people at once. You might have a friend over for lunch initially, but eventually, be able to meet someone at a crowded restaurant during a busy lunch hour.

Fear of being the center of attention

People who fear being the center of attention due to social anxiety typically avoid being in social settings so they won’t ever be the center of attention. They’ll likely immediately deflect conversations if the focus ever turns to them. You can start by practicing solo public speaking, role-playing with a therapist or someone you are comfortable with, or going into public settings alone to desensitize yourself.

Fear of conflict

When social anxiety involves a fear of conflict, people might stifle their thoughts or reactions to protect themselves from their words being used against them.

You can overcome a fear of conflict by learning conflict resolution skills and practicing assertiveness through cognitive therapy. You’ll slowly build up to situations where you feel ready to deal confidently with conflict.

To build confidence, you can also start in low-traffic areas before attempting to drive on busier roads and highways.

Online Exposure Therapy from the Comfort of Your Home

Sometimes the thought of in-person therapy can be overwhelming — this is often especially true for people with social anxiety. By taking an online social anxiety test, you can validate your experiences, which can empower you to seek appropriate treatment aimed at helping you learn effective strategies for managing your symptoms. Talkspace, an online therapy platform that makes getting exposure therapy for social anxiety possible from the comfort of your home, might be the type of care you’ve been looking for.

Talkspace offers exposure therapy sessions with highly qualified therapists who know how to treat social anxiety. Learn more about how Talkspace can take some of the stress out of getting help for your anxiety, so you can conquer the next social event that comes your way.

See References

Karmen Smith

Dr. Karmen Smith is a board-certified Clinical Social Worker in the state of Nevada. She has worked over 20 years for Clark County Family Services with abused and neglected children in the shelter, adolescents in juvenile detention, and adults who have suffered severe trauma. Dr. Smith is a shamanic teacher and minister of metaphysics and her doctorate is in Pastoral Counseling.

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