What Keeps Social Anxiety Going?

The What Keeps Social Anxiety Going? handout presents key factors that maintain social anxiety disorder.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

Overview

The "What Keeps It Going?" series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, they provide an easy way for clients to understand at a glance why their disorders persist, and how they might be interrupted.

What Keeps Social Anxiety Going? is designed to help clients with social anxiety understand more about their condition.

Why Use This Resource?

Understanding what keeps social anxiety disorder going is crucial for effective intervention. By identifying these factors, therapists can develop idiosyncratic models of clients' experiences and focus their interventions.

Highlights and explains key factors that maintain social anxiety.
Provides a visual model that to facilitate discussion and inform case conceptualization.
Helps clients better understand the difficulties they are experiencing.

Key Benefits

Insight

Provides insights into what perpetuates social anxiety disorder.

Guidance

Serves as a roadmap for therapeutic discussions and formulations.

Understanding

Helps clients comprehend their difficulties and the ways to address them.

Engaging

Simplifies complex ideas and explanations, enhancing understanding and communication.

Who is this for?

Social Anxiety

Designed to help clients affected by social anxiety.

Integrating it into your practice

Introduce

Explain to the client that certain difficulties persist due to cycles that maintain them.

Discuss

Use the handout to discuss what might be keeping the client's difficulties going.

Identify

Pinpoint and personalize maintaining factors that are relevant to the client.

Strategize

Explore how these maintaining cycles can be interrupted.

Theoretical Background & Therapist Guidance

Research studies have shown that Cognitive Behavioral Therapy (CBT) is one of the most effective treatments for social anxiety (Mayo-Wilson et al, 2014). CBT therapists work a bit like firefighters: while the fire is burning they aren’t very interested in what caused it, but are more focused on what is keeping it going. This is because if they can work out what keeps the problem going, they can treat it by ‘removing the fuel’ and interrupting this maintaining cycle.

In 1995, psychologists David Clark and Adrian Wells published an influential model of social anxiety which identified the key components that are thought to explain why some people’s social anxiety persists. The What Keeps Social Anxiety Going? information handout describes some of these key factors, which maintain social anxiety. It illustrates these maintaining factors in a vicious cycle or 'flower' format in which each ‘petal’ represents a separate maintenance cycle. Helping clients to understand more about the cognitive model is an essential part of cognitive therapy for social anxiety (Warnock-Parkes et al, 2020). Therapists can use this handout as a focus for discussion, or as a template from which to formulate an idiosyncratic model of a client’s experiences of social anxiety.

What's inside

Introduction and overview of social anxiety disorder.
Guidance for introducing the resource to clients.
Template for developing personalized maintenance cycles.
Key references for learning more about social anxiety.

Get access to this resource

FAQs

It can serve as a discussion point and a template for creating personalized formulations, helping clients understand what maintains their difficulties.

Introduce it as a framework for gaining a deeper understanding of their difficulties and the reasons why they persist.

Use it as a starting point to explore unique factors that are specific to the client's experience, and tailor the diagram accordingly.

How This Resource Improves Clinical Outcomes

This resource aims to:

Increase insight into the processes maintaining clients' difficulties.
Support collaborative formulation and treatment planning.
Present key information in a structured, understandable format.

Therapists benefit from:

A clear framework that helps explain why problems persist.
A visual tool to enhance communication and understanding.
An adaptable resource that can be tailored to clients' unique experiences.

References And Further Reading

Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. Heimberg, M. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment and treatment. New York: Guilford Press, pp. 69–93.

Mayo-Wilson, E., Dias, S., Mavranezouli, I., Kew, K., Clark, D. M., Ades, A. E., & Pilling, S. (2014). Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. The Lancet Psychiatry, 1(5), 368-376.

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.