Understanding Social Anxiety

It is common to feel a bit of anxiety around other people from time to time. If the anxiety is more severe than regular shyness, and interferes with an individual’s ability to live their life, they may be suffering from social anxiety: one of the most common anxiety disorders. It is thought that between 2 and 7 people out of every 100 experience social anxiety disorder every year. The good news is that Cognitive Behavioral Therapy (CBT) is an effective psychological treatment for social anxiety disorder. 

The Understanding Social Anxiety guide is designed to help clients with social anxiety to understand more about their condition. As well as a clear description of symptoms and treatments, the guide explores key maintenance factors for social anxiety including:

• Self-image / self-impression.
• Beliefs and assumptions.
• Negative automatic thoughts (NATs) and images.
• Self-consciousness and self-focused attention.
• Safety behaviors and avoidance.
• Anticipatory anxiety and worry.
• ‘Replaying’ social events (post-morteming) and rumination.

• Scaffold knowledge. The guides are perfect during early stages of therapy to help your clients understand how their symptoms fit together and make sense.
• Reassure and encourage optimism. Many clients find it hugely reassuring to know there is a name for what they are experiencing, and that there are evidence-based psychological models and treatments specifically designed to help.
• De-mystify the therapy process. To increase your client’s knowledge of the therapy process and the ingredients that it is likely to involve. If you can help your clients to understand why an intervention is important (think exposure!) it can help encourage them to engage.
• Signposting. If you’re just seeing a client briefly for assessment, or you have a curious client who wants to know more, these resources can be a helpful part of guiding them to the right service.
• Waiting time not wasted time. When you’ve assessed someone but their treatment can’t begin right away, psychoeducation can help them learn about how therapy can help while they’re waiting.

• Case examples to help your clients relate to the condition, and to normalize their experiences.
• Jargon-free descriptions of symptoms, and descriptions of how they might affect your thoughts, feelings, and actions.
• A symptom questionnaire for screening assessment.
• An accessible cognitive-behavioral account of what keeps the problem going, or what stops it from getting better.
• A description of evidence-based treatments for that condition, including an overview of the ‘ingredients’ of a good cognitive behavioral approach.

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• National Institute for Health and Care Excellence (NICE: 2013). Social; anxiety disorder: rec- ognition, assessment, and treatment. Retrieved from: https://www.nice.org.uk/guidance/cg159/ resources/social-anxiety-disorder-recognition-assessment-and-treatment-pdf-35109639699397
• Stein, D. J., Lim, C. C., Roest, A. M., De Jonge, P., Aguilar-Gaxiola, S., Al-Hamzawi, A., ... & De Girolamo, G. (2017). The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC medicine, 15(1), 143.
• Warnock-Parkes, E., Wild, J., Thew, G. R., Kerr, A., Grey, N., Stott, R., ... & Clark, D. M. (2020). Treating social anxiety disorder remotely with cognitive therapy. The Cognitive Behaviour Therapist, 13.