Cognitive behavioral therapy for social anxiety disorder
Cognitive behavioral therapy (CBT) is the most widely studied and validated psychotherapy treatment for social anxiety disorder. The goal of treatment is to manage social anxiety by lowering anxiety symptoms and enabling individuals to participate in previously avoided social situations. CBT is a collaborative process and requires motivation to change old habits and learn better ways to deal with social situations. In CBT, patients acquire skills to better cope with social situations and break the cycle of anxiety. They learn to identify anxious thoughts that are common in anticipation of or during a social encounter. Examples of anxious thoughts: "I'm going to be nervous," "I'm going to look like a fool," "I'm going to totally fail." These thoughts increase anxiety and interfere with social interactions. Patients will learn to evaluate and challenge these thoughts and develop more realistic, alternative perspectives.
An important component of treatment is exposure exercises, which helps to overcome avoidance that is common in social anxiety disorder. During exposure exercises, the patient learns to gradually confronts anxiety-provoking situations. They practice participating in social situations, first in the session with the therapist, and then branching to real life settings. Exposure exercises are developed collaboratively, and are always conducted in a controlled, systematic way, and paced gradually from less fearful to more anxiety-provoking situations.