What is Social Anxiety?
Social anxiety is characterized by fear of embarrassment or judgement in social situations and tends to begin in adolescence. Individuals with social anxiety experience a range of physiological (e.g., sweating, increased heart rate, flushing, lightheaded, "jelly" legs), social (e.g., avoiding work or friends), cognitive (e.g., mind going "blank", negative thoughts) and behavioral (e.g., avoidance) symptoms. Social anxiety is manifested in some of the following contexts:
- Giving a speech/speaking in public
- Asking someone on a date
- Answering/Talking on the phone
- Eating in public
- Using public restrooms
- Worrying about offending someone
- Fear of throwing up in public
- Interviewing for a job
What is Comprehensive CBT (CCBT) for Social Anxiety?
Our 12- week CCBT for Social Anxiety Program includes both individual and skills class (group) formats. The treatment incorporates several strategies in the following contexts:
Exposure through Role Plays
Cognitive Restructuring Exercises (e.g., identify and evaluate beliefs)
Social Skills Training through Modeling and Coaching
Components of the CCBT Program:
Skills Classes (Group)
Classes include 6-10 participants and focus on skill acquisition and application in a supportive environment with real-time feedback. Classes are co-led by two therapists. Class is Monday from 5:00-6:30 pm. Sessions 1-2 are an introduction to CBT and social anxiety, sessions 3-4 are devoted to skills training (e.g., initiating, maintaining, and ending conversations, as well as compromise and negotiation), and sessions 5-12 involve exposure simulation, cognitive and behavioral skills acquisition, identification of cognitions, and generalization of skills to multiple contexts.
Patients meet with their individual therapists for several weeks of pre-treatment (before skills class begins) to develop goals, create a hierarchy of fears, and gain preliminary insight into their symptoms. Patients may also inquire about medication options during pre-treatment.
Homework is a required and essential part of CCBT for Social Anxiety in order to generalize skills to a variety of contexts. Participants in the program should expect daily homework that will be of increasing "intensity" to help challenge and overcome feared situations. Patients will also complete thought-logs which allow for the evaluation of inaccurate beliefs and development of alternative beliefs.