Cognitive Behavioral Therapy for Social Anxiety Disorder

Table of ContentsView AllTable of ContentsGoalsCBT TechniquesBehavioral TechniquesInternet CBT

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CBT Techniques

Behavioral Techniques

Internet CBT

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Social anxiety disorder (SAD) is commonly treated with cognitive behavioral therapy (CBT), which was pioneered in the 1960s for the treatment of depression. It is now a leading treatment for many other conditions, includinganxiety 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 differs from CBT for SAD or other anxiety disorders. Because there are so many techniques, it is important to choose a therapist who has experience in treating SAD.

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

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Goals of CBT for SAD

One of the central goals of CBT is to identifyirrational beliefsand 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:

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.

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Keys for Success

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.

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 thoughtsthat occur automatically and are out of step with reality. These thoughts increase anxiety and lessen your ability to cope.

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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.

RecapThe 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.

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.

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Another element of CBT that focuses on changing socially anxious behaviors is known assystematic 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.

RecapExposure 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.

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

Internet CBT for SAD

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.

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A Word From Verywell

CBT is one of the most effective treatments for SAD. It can help you change negative thoughts that contribute to anxiety, learn new coping strategies, and gradually decrease fear in social situations.

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

4 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.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:26487814U.S. National Library of Medicine.Cognitive Behavioral Therapy.U.S. National Library of Medicine.Social anxiety disorder.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.pub2Additional ReadingHofmann SG, Smits JA.Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials.J Clin Psychiatry. 2008;69(4):621-32. PMID:18363421Hofmann SG.Cognitive factors that maintain social anxiety disorder: a comprehensive model and its treatment implications.Cogn Behav Ther. 2007;36(4):193–209. doi:10.1080/16506070701421313

4 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.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:26487814U.S. National Library of Medicine.Cognitive Behavioral Therapy.U.S. National Library of Medicine.Social anxiety disorder.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.pub2Additional ReadingHofmann SG, Smits JA.Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials.J Clin Psychiatry. 2008;69(4):621-32. PMID:18363421Hofmann SG.Cognitive factors that maintain social anxiety disorder: a comprehensive model and its treatment implications.Cogn Behav Ther. 2007;36(4):193–209. doi:10.1080/16506070701421313

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

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:26487814U.S. National Library of Medicine.Cognitive Behavioral Therapy.U.S. National Library of Medicine.Social anxiety disorder.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

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

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

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

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

Hofmann SG, Smits JA.Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials.J Clin Psychiatry. 2008;69(4):621-32. PMID:18363421Hofmann SG.Cognitive factors that maintain social anxiety disorder: a comprehensive model and its treatment implications.Cogn Behav Ther. 2007;36(4):193–209. doi:10.1080/16506070701421313

Hofmann SG, Smits JA.Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials.J Clin Psychiatry. 2008;69(4):621-32. PMID:18363421

Hofmann SG.Cognitive factors that maintain social anxiety disorder: a comprehensive model and its treatment implications.Cogn Behav Ther. 2007;36(4):193–209. doi:10.1080/16506070701421313

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