Cognitive Behavioral Therapy (CBT) for Social Anxiety

Published on: 01 Feb 2022
Clinically Reviewed by Jill E. Daino, LCSW-R
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Social anxiety, or social phobia, is a mental health condition marked by persistent feelings of dread, worry, and nervousness. The feelings can onset when you’re actually in a social situation, or they surface just at the thought of being at a gathering. Some signs you have social anxiety include:

  • Being excessively self-conscious near others
  • Experiencing physical symptoms of anxiety
  • Being preoccupied with what others think of you
  • Assuming that nobody wants to be your friend
  • Fearing that you’re going to embarrass yourself somehow
  • Isolating yourself from everyone except, maybe, a few trusted loved ones

If you experience symptoms like those listed above, therapy can be very helpful. The exact therapy strategy that’ll work best for you will be based on your symptoms and history. In general, online cognitive behavioral therapy (CBT) for social anxiety is known to be quite effective.

Cognitive behavioral therapy for social anxiety teaches you to be mindful of and explore your thoughts, behaviors, and emotions causing you to feel distressed and anxious in social settings. Doing so can significantly decrease social anxiety symptoms or perhaps alleviate them completely.

How Does CBT Work for Social Anxiety?

CBT for social anxiety teaches the skills that help people analyze their anxious thoughts, behaviors, and emotions. The goal is to change what’s driving the feelings of self-consciousness and to reduce the physical symptoms experienced.

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Start CBT to learn to identify and reframe negative thought patterns and develop positive coping skills

Cognitive behavior therapy helps you recognize and reframe distorted thought patterns. The CBT treatment also teaches you various ways to cope with social anxiety symptoms both before and during a symptomatic episode.

“How we think about social settings determines how we feel and therefore respond. So CBT involves challenging thoughts, perspectives, and ideologies that have given us less than desirable outcomes in our lives. We learn to see our lives from a different angle and that clarity can be enough to create new, functional habits.”

Talkspace therapist Meaghan Rice, PsyD, LPC

Commonly Used CBT Techniques for Social Anxiety 

There are various cognitive behavioral therapy techniques that help reduce the frequency and intensity of social anxiety symptoms. The specific techniques that’ll work best for you will depend on your unique symptoms and situation.

With social anxiety, the negative beliefs and feelings you hold about yourself can trigger anxious responses, including:

  • Not making eye contact
  • Going to great lengths to avoid conversations
  • Experiencing physical symptoms of anxiety
  • Agreeing with everyone so you can exit a conversation sooner

Your CBT therapist will likely use one or more of the following techniques to help you understand, cope with, and heal from your social anxiety.

“Challenging “all or nothing” thinking is a commonly used CBT technique a therapist can teach you. People who tend to think in a linear fashion (i.e.: there’s only one path to achieve an outcome) are often less likely to achieve happiness than those who can think about multiple paths to get to the desired destination. Exploring these details with a CBT-trained therapist can support people in enhancing their resilience because they’ll feel less ‘stuck’ if that initial path doesn’t work out the way they hoped.”

Talkspace therapist Meaghan Rice, PsyD, LPC

Attention training

Attention training is a CBT technique that involves shifting your attention to other people instead of yourself. While focusing on your thoughts, feelings, and behaviors certainly has its benefits, it can leave you tuned out to others.

Intentionally paying attention to what others are saying during a conversation allows you to shift the focus from yourself. This can in turn allow you to recognize that others aren’t nearly as concerned about you as you once believed them to be.

You’ll likely find that what others talk about has very little — or nothing at all — to do with the thoughts and beliefs you’re typically preoccupied with.

Psychological education

Learning about the psychological aspects that contribute to social anxiety can help you better-understand yourself. It’ll teach you how certain behaviors that lead to avoidance are making your social anxiety worse.

Your CBT therapist will also explain how cognitive therapy can work to reduce your anxiety. They’ll offer advice about how the technique reframes your thinking patterns to reduce your symptoms.

Cognitive restructuring

This CBT technique involves examining the negative thoughts and distorted beliefs that arise during social situations. Some of these might include:

  • Over-generalizing
  • Everything-or-nothing thinking patterns
  • Believing that everything is bound for catastrophe
  • Ignoring all positive aspects and focusing on negatives
  • Believing that your emotions are truth (emotional reasoning)

Once you’re able to identify these inaccurate beliefs and feelings, you empower yourself to recognize them sooner in the future. This is part of the process of restructuring the ways that you currently perceive yourself.

There are various other psychological techniques that a cognitive behavioral therapist may use. The combination of learning and practicing new methods for analyzing and understanding your emotions will help you experience fewer and fewer symptoms over time.

How Effective is CBT for Social Anxiety Disorder?

There’s a solid amount of research-based evidence that cognitive behavioral therapy works well at reducing the severity and frequency of social anxiety symptoms. Numerous studies have shown the incredible efficacy of CBT for social anxiety.

  • CBT appears to have more benefits for treating social anxiety symptoms than prescription medications, practicing self-help techniques, and some other treatment approaches.
  • Cognitive behavior therapy might be more effective at reducing social anxiety than exposure therapy combined with applied relaxation sessions.
  • CBT may help lessen avoidance and feelings of self-consciousness. However, it might not reduce fears of criticism or poor evaluations from others.
  • Cognitive behavioral therapy seems to help alleviate social anxiety symptoms that are resistant to certain medications for depression.

CBT continues to gain popularity as an effective treatment for social anxiety and other disorders marked by irrational fear and panic symptoms.

How Long Does CBT Take for Social Anxiety?

It’s important to note that social anxiety disorder cognitive behavioral therapy is not a “quick fix.” It takes multiple sessions with a therapist and a sincere desire to cooperate in the reframing process. This can take weeks or months to see results in some cases as you work to reframe your anxiety. 

However, many people begin experiencing benefits after the first session. The act of seeking professional help and going to the initial appointment is life-changing for many.

Finding a CBT Therapist 

Finding a social anxiety disorder cognitive behavioral therapy provider is easy, and you’ve already made it through the hard part. You decided to get help. Talkspace makes finding a therapist simple, convenient, and affordable. You can get the cognitive behavioral therapy for social anxiety you’ve been looking for, so you can be on your way to living a fulfilling, happy, social life. 

Sources:

1. Mayo-Wilson E, Dias S, Mavranezouli I et al. Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. The Lancet Psychiatry. 2014;1(5):368-376. doi:10.1016/s2215-0366(14)70329-3. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(14)70329-3/fulltext. Accessed December 24, 2021.

2. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Anxiety. 2015;17(3):337-346. doi:10.31887/dcns.2015.17.3/akaczkurkin. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610618/. Accessed December 24, 2021.

3. Pinjarkar R, Sudhir P, Math S. Brief Cognitive Behavior Therapy in Patients with Social Anxiety Disorder: A Preliminary Investigation. Indian J Psychol Med. 2015;37(1):20-25. doi:10.4103/0253-7176.150808. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341305/. Accessed December 24, 2021.

4. Yoshinaga N, Matsuki S, Niitsu T et al. Cognitive Behavioral Therapy for Patients with Social Anxiety Disorder Who Remain Symptomatic following Antidepressant Treatment: A Randomized, Assessor-Blinded, Controlled Trial. Psychother Psychosom. 2016;85(4):208-217. doi:10.1159/000444221. https://www.karger.com/Article/Fulltext/444221. Accessed December 24, 2021.

5. Rodebaugh T, Holaway R, Heimberg R. The treatment of social anxiety disorder. Clin Psychol Rev. 2004;24(7):883-908. doi:10.1016/j.cpr.2004.07.007. https://pubmed.ncbi.nlm.nih.gov/15501560/. Accessed December 24, 2021.

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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