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Social anxiety: Cognitive Behavioural Therapy CBT treatment

The two main conventional treatments for social anxiety disorder are: cognitive behavioural therapy CBT and medication. Sometimes both may be used at the same time.

Cognitive behavioural therapy CBT

The central concept of the cognitive part, of cognitive behavioural therapy CBT is; what we think affects how we feel and what we do. It focuses on your cognition. Another way to view this, is that cognitive therapy focuses on your self-talk i.e. what you say to yourself all day long.

The behavioural part, of cognitive behavioural therapy CBT, focuses on behaviour rather than the internal thought processes. It includes approaches on how to condition behaviour, using principals like pain and pleasure i.e. we tend behave in a way to avoid pain and/or to gain pleasure.

Cognitive behavioural therapy CBT is a combination of both cognitive and behavioural approaches. However, the emphasis is generally on the cognitive part.

The use of cognitive behavioural therapy in social anxiety disorder will include things like:

  • An explanation of social anxiety disorder.
  • An explanation of how your thoughts affect how you feel and act.
  • An explanation of the concept that the world is not the actual world itself, but your interpretation of it.
  • How your thoughts/beliefs/opinions affect how you interpret the world around you.
  • Exercises to reveal your own personal negative automatic thoughts NATs and self-limiting or negative beliefs.
  • Challenging negative automatic thoughts NATs and negative or self-limiting beliefs to see if they have any basis in reality.
  • Introducing positive thoughts and beliefs that will be helpful to you, in overcoming social anxiety.
  • Exposure therapy; where you are increasingly exposed to situations which cause anxiety. The aim is that eventually your anxiety reduces to a level which allows you to function adequately.

Cognitive behavioural therapy is usually done one-to-one with a psychologist. It is a process which can take months. It does require a degree of effort and determination to make it work.

Take care,


Dr Paul Ogilvie
Dr Paul Ogilvie