Social anxiety is a silent, stay-at-home epidemic of social avoidance. One in four Australians experience anxiety, and around 11% of the population will experience social anxiety in their lifetime. Cognitive-behavioural therapy (CBT) is an incredibly effective treatment for social anxiety, but the majority of people don’t seek help – why?
Social anxiety is a treatable mental health condition, but many people mistakenly believe that anxiety is a fixed personality trait.
Shyness and introversion are often confused with social anxiety – yet extroverts can feel shy, just as introverts can be highly sociable!
Social anxiety can affect anyone – from children to adults, regardless of their personality type
Social anxiety isn’t a life sentence, though: the latest research indicates that symptoms of social anxiety are significantly reduced with the use of cognitive-behavioural therapy in counselling.
Symptoms of social anxiety
In a nutshell, social anxiety is often the intense dread or fear of being judged or scrutinised by others – or embarrassing oneself – leading to avoidance of social interactions.
You might feel cripplingly self-conscious about other people’s opinions of you and tend to assume they’re thinking the worst. Or you might constantly rehash social interactions, looking for instances where you feel that you fell flat socially.
Often there’s also a fear that other people have noticed your anxiety, which compounds any feelings of self-doubt and awkwardness. This is especially true for people who show involuntary physical signs of anxiety, like trembling hands or hyperventilation.
Some of the physical symptoms of social anxiety include:
- Racing heartbeat
- Excess perspiration, especially hands
- Stammering or rapid speech
- Panic attacks
Social anxiety triggers
Social anxiety is a strange and sneaky beast. Even the most innocuous situations can trigger intense fear of humiliation and panic.
For instance, some people have a morbid dread of using a public restroom, whilst for others writing or eating in front of other people would risk someone noticing their hands shake.
Making small talk, meeting new people, speaking to people in authority, being the centre of attention… the list of situations that can create acute discomfort and worry is endless.
The Liebowitz Social Anxiety Scale (LSAS) is an empirically validated self-report survey that assesses levels of social anxiety in a range of situations.
Scoring 30 or above may indicate mild social anxiety, whereas scores of 54 or higher may indicate a generalised social phobia.
You can take the LSAS by clicking on the image below:
Please note: If you would like to talk to a social anxiety specialist about the results of your LSAS, please get in touch.
Social anxiety and cognitive behavioural therapy
Ready for some sweet relief from the symptoms of social anxiety?
Cognitive behavioural therapy (CBT) is the key
In fact, CBT has consistently shown significant efficacy in reducing – and in many cases completely resolving – the debilitating symptoms of social anxiety.
Check out these research findings:
A 2016 randomised clinical trial found that CBT alone was the most effective treatment for social anxiety (compared to medication, a combination of CBT and medication, and placebo).
At the 12-month follow-up,
“68% of participants assigned to CBT counselling had experienced full recovery”
as compared to 40% in the combination group, 20% in the medication group, and 4% in the placebo group.
A secondary analysis by the same researchers revealed that positive changes in metacognition (our understanding and awareness of our own thought processes) brought about via CBT were the most consistent predictor of recovery from social anxiety.
How does Cognitive behavioural therapy (CBT) work?
The cognitive component of CBT targets the fearful and distorted thinking that is a hallmark of social anxiety.
The behavioural element of CBT puts coping strategies into action.
Cognitive behavioural therapy helps people to:
- Identify the underlying causes that trigger social anxiety
- Test and deconstruct fear-based thoughts using logic and reason
- Focus on the present moment using mindfulness-based techniques
- Reduce social anxiety via graduated exposure to anxiety-inducing situations and triggers, using stress reduction strategies
Social anxiety and young people
CBT is also proving an especially effective treatment for anxiety disorders in children and adolescents. A recent meta-analysis that compared 19 trials investigating complete recovery from all anxiety disorders demonstrated that:
- 47.6 to 66.4% of children experienced a full recovery from anxiety after CBT counselling
- Rates of complete recovery in young people with an Autism Spectrum Disorder ranged from 12.2 to 36.7% after CBT
These encouraging results are supported by the findings of another meta-analysis. This study specifically examined the effects of CBT treatment for social anxiety in young people. The researchers reported that the effectiveness of CBT in reducing symptoms of social anxiety was significantly enhanced when the children were also given social skills training.
Getting help for social anxiety
For some people, the mere thought of going to see a counsellor or psychologist can trigger their social anxiety symptoms.
Many people seeking help for social anxiety prefer Phone or Skype counselling. There is a strong evidence base that this form of anxiety counselling is equally as effective as in-person sessions – with the added benefit of accessing specialist support from the familiar surrounds of your home.
Counselling is a safe, nonjudgmental environment for you to explore your concerns, formulate an action plan to reduce social anxiety, and start living your life free from the fear of rejection or humiliation.
Social anxiety can be treated. Cognitive-behavioural therapy makes recovery a reality.
Social anxiety and cognitive behavioural therapy research resources:
Gregory, B., & Peters, L. (2016). Changes in the self during cognitive behavioural therapy for social anxiety disorder: A systematic review. Clinical Psychology Review.
Nelson, E. L., & Duncan, A. B. (2015). Cognitive behavioural therapy using televideo. Cognitive and Behavioural Practice, 22(3), 269-280.
Nordahl, H., Nordahl, H. M., Hjemdal, O., & Wells, A. (2017). Cognitive and metacognitive predictors of symptom improvement following treatment for social anxiety disorder: A secondary analysis from a randomised controlled trial. Clinical Psychology & Psychotherapy.
Nordahl, H. M., Vogel, P. A., Morken, G., Stiles, T. C., Sandvik, P., & Wells, A. (2016). Paroxetine, cognitive therapy or their combination in the treatment of social anxiety disorder with and without avoidant personality disorder: A randomised clinical trial. Psychotherapy and Psychosomatics, 85(6), 346-356.
Warwick, H., Reardon, T., Cooper, P., Murayama, K., Reynolds, S., Wilson, C., & Creswell, C. (2017). Complete recovery from anxiety disorders following cognitive behavioural therapy in children and adolescents: A meta-analysis. Clinical Psychology Review, 52, 77-91.
Scaini, S., Belotti, R., Ogliari, A., & Battaglia, M. (2016). A comprehensive meta-analysis of cognitive behavioural interventions for social anxiety disorder in children and adolescents. Journal of Anxiety Disorders, 42, 105-112.
Marcus Andrews is the founder and director of Life Supports, which was established in 2002. He has extensive professional experience working as a counsellor and family therapist across a broad range of issues. The core component of his role at Life Supports involves the supervision of other counsellors, including secondary consultations. Marcus has worked in many sectors, including private, government, non-profit, health, forensic and community practice.