This Social Anxiety Formulation worksheet is designed to help therapists and clients to develop an idiosyncratic case conceptualization of a client’s social anxiety.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.
An editable Microsoft PowerPoint version of the resource.
People suffering from social anxiety disorder (previously known as social phobia) experience persistent fear or anxiety concerning social or performance situations that is out of proportion to the actual threat posed by the situation or context. They fear negative evaluation and worry excessively about social events and outcomes, both before social situations and afterwards. Common fears include speaking or acting in ways that they think will be embarrassing or humiliating, such as shaking, sweating, blushing, freezing, appearing stupid or incompetent, or looking anxious. They fear that other people will judge them negatively, for example that they appear anxious, stupid, crazy, boring, dirty, or unlikable. They therefore make efforts to ensure that their fears do not materialize, resulting in clinically significant distress and impairment, often across multiple domains of their life. The Social Anxiety Formulation worksheet is designed to help therapists in developing a nuanced understanding of the components underlying their client's social anxiety. Therapists can use this tool to help clients map their experiences and understand how their anxiety is maintained.
Using this worksheet can lead to more effective, targeted therapeutic interventions for social anxiety:
Clients fearing negative evaluation in social or performance situations.
Individuals experiencing disabling anxiety in situations like public speaking or group interactions.
Clients who equate self-worth with social performance.
Gather information about specific situations in which a client's social anxiety is triggered.
Explore the client's negative self-perception, emotions, and behaviors.
Help your client draw connections between their cognitive processes, emotional reactions, and safety behaviors.
Collaboratively identify strategies to explore, test, or challenge unhelpful beliefs and behaviors.
Formulate a personalized treatment plan based on this detailed understanding.
People with social anxiety believe that social situations pose a danger. They fear negative evaluation, believing in particular that “(1) they are in danger of behaving in an inept and unacceptable fashion, and, (2) that such behavior will have disastrous consequences in terms of loss of status, loss of worth, and rejection” (Clark & Wells, 1995).
People with social anxiety worry excessively about these events and outcomes, both in anticipation of social situations and afterwards. Common fears include speaking or acting in ways that they think will be embarrassing or humiliating, such as shaking, sweating, blushing, freezing, appearing stupid or incompetent, or looking anxious. They fear that other people will judge them negatively, for example that they appear anxious, stupid, crazy, boring, dirty, or unlikable. People with social anxiety make efforts to ensure that their fears do not materialize, resulting in clinically significant distress and impairment often across multiple domains of their life.
Clark & Wells (1995) proposed a cognitive behavioral model explaining the persistence of social anxiety. This model identifies dysfunctional beliefs, perceived social danger, and self-focused attention as central to social anxiety. It highlights how self-monitoring and safety behaviors can maintain anxiety by skewing perceptions and inhibiting corrective feedback. Understanding this model helps therapists address key components maintaining a client’s anxiety, aiding effective intervention strategy development.
By clarifying the psychological mechanisms which are believed to underpin of social anxiety, this worksheet helps clinicians deliver more focused therapy, aiming for cognitive change, reduced avoidance, and improved social functioning. Therapists can develop tailored interventions that better address each client's unique challenges.
