Cbt activities for social anxiety (5+)

In this blog, we will learn about the various activities and exercises in Cognitive Behavioral Therapy for social anxiety. 

What are the activities for Social anxiety in CBT?

There are numerous techniques and activities utilized in Cognitive Behavioral Therapy to deal with Social anxiety. Some of them are as follows

  • Cognitive Restructuring
  • Relaxation Exercises
  • Exposure Techniques
  • Systematic Desensitization
  • Behavioral Experiments
  • Role Play
  • Guided Imagery

Social Anxiety and its Symptoms

Social anxiety disorder, which is also known as social phobia, is a fear of social situations. The onset of this phobia is usually during the adolescent period. It can be very distressing and have a big impact on a person’s life. This disorder, in most instances, gets better with time as people get older. But for some treatment is the on;y way to help with this disorder. If a person is displaying symptoms of SAD it is important to seek help from a professional as there are various treatments available to help deal with Social Anxiety,

Symptoms of social anxiety

Social anxiety is often misconstrued as shyness or introversion but it is actually a type crippling and overwhelming fear that can severely affect a person’s interpersonal relationships, self-confidence, academic, professional, and social life. 

While being worried about social situations and events occasionally is quite normal, people with social anxiety are perpetually worried about social situations and their worry and anxiety towards these events is excessive and overwhelming. 

A person might have social anxiety if they possess the following symptoms:

  • Get anxious and worried about daily life activities, even something as common as meeting strangers, having conversations (even small talk), speaking with someone on the phone, shopping, eating in a restaurant, ordering food, etc.
  • Prefer to avoid going to social gatherings or parties where they will unavoidably be in the company of people and will be expected to interact. 
  • Constantly fretting over embarrassing oneself in front of people by behaving in a way that they think is inappropriate or embarrassing. For example, fearing to eat in front of others, or thinking that sweating or blushing is not appropriate. 
  • Being terrified of drawing people’s attention towards oneself. Or thinking that everyone is judging them every time someone even looks at them.  
  • Do not like being criticized and being scared of looking incompetent in front of others 
  • Avoiding eye contact, having low self-esteem, being unable to speak with people out of their comfort zone, being alone and isolated.
  • Display symptoms such as nausea, stomach ache, palpitations, sweating, and body tremors. 
  • Panic attacks 

Techniques of CBT for Anxiety 

Cognitive Behavioral Therapy has a very vast range of techniques, strategies, and methods to deal with mental health issues. These techniques have been proved to be very effective in the treatment of social anxiety. The techniques are:

ABC Model 

The ABC model is a very beneficial tool in the arsenal of CBT techniques. It is designed in a way to help evaluate and analyze the events and situation and their outcomes by observing their relationship with the person’s thought process and emotions. 

A – Activating event.

B – Beliefs: 

C –Consequence

When we analyze a situation with the help of this model and break it down into three categories we can observe a pattern within our behavior due to the relationship between the three components of this model.  Thus, this method provides us with the information to help us change our cognitive distortions and modify them into adaptive thoughts and ideas to obtain desirable behavior.

Example

Let’s suppose a person has stage fright and cannot perform on stage in front of an audience.

If we analyze the situation through this tool we can break down the situation in the following way

A: Activating Event

 A bad stage performance where everyone laughed when she slipped

Whenever she has to perform onstage her anxiety is triggered and she is overcome with extreme fear and cannot perform because she remembers this past incident and is still

traumatized due to it

B: Beliefs

I am laughable, I am not a good performer, Everybody will laugh at me if I perform badly

These beliefs have become ingrained within her mind and she refuses to believe these are untrue or irrational. 

C: Consequence

The outcome of this scenario is that due to extreme anxiety even if she somehow tries to perform she is not able to perform well, which further reinforces her irrational beliefs that she is not good enough.  

Therefore it is necessary to dispute her cognitive distortions by providing evidence against those beliefs and help her conquer her fear of stage by slowly easing her into the situation. 

S.M.A.R.T.

S.M.A.R.T is an acronym for a set of goals that assist in dealing with anxiety. These goals are determined and set by the individual with the help of the therapist to help them overcome their anxiety. 

The S.M.A.R.T. goals stand for

S: Specific 

These goals are highly structured, specific, and defined clearly. There is no scope of ambiguity in these goals and therefore the client should be aware of and determined about the expected outcome from these goals.

M: Measurable 

These goals are measurable and hence people can track their progress and achievements easily.

A: Achievable

Even though these goals are highly structured and specific, they are still attainable. But the person must have the skill and determination as well as resources to reach the goal

R: Relevant/Realistic

The person should be focused and willing to work hard and devote their hard work as well as time for the sake of these goals

T: Time-bound

These goals are time-specific and need to be completed within the set time. 

Example of SMART goals

A person might set a goal of making small talk with 3 strangers every day for a month. 

This goal meets all the above-mentioned criteria; it is specific, measurable, achievable, realistic, and time-bound. Also, it helps in getting the person to step out of their comfort zone at their own pace without pressuring them.

Exposure Therapy

Exposure therapy is one of the best and most reliable methods of dealing with social anxiety.

People tend to have a phobia of a particular object, thing, or situation. Due to this fear they often run away from any situations or events where they will have to confront their fears which further exacerbates the fear.  Therefore exposure therapy is a great way of making them familiar with their fears and helping them understand that they can survive those situations intact without being harmed. Exposure therapy aims to desensitize people to their fears.

There are several types of exposure therapy, they are as follows:

In vivo exposure:

In vivo exposure involves confronting the fears to reduce their impact gradually over time. This means that people have to face events or objects that generate fear within them in real life. So if a person has social anxiety then through this technique the therapist may ask the person to engage in social activities that generate fear within them. 

Imaginal exposure: 

Unlike in vivo exposure in this technique, the person is not expected to confront their fears in real life but through imagination. The person would be asked to visually imagine the stimulus that provokes anxiety within them. For social anxiety, it would involve imagining a social situation that makes them anxious.

Virtual reality exposure:

In this technique, the person is exposed to stimuli through technology. The individual could be virtually exposed to a social event or situation that they fear (such as speaking in front of a large crowd). The advantage of this technique is that it works as a great simulation method for the person to practice and evaluate their behavior in their feared situation without actually being in that situation. 

Graded exposure:

In this technique, the individual’s fears are ranked based on the fear they evoke in the person and are ranked accordingly in the fear hierarchy. The exposure is started with the lowest-ranked fear and slowly graduates to high-ranking fears. 

Flooding:

This intervention technique just like the graded exposure techniques consists of a hierarchy system. But here the fear that ranks the highest is exposed to the client first followed by the fear that is less fear-provoking than the first. Basically, this method follows a descending pattern of fear exposure 

Relaxation Exercises

Relaxation exercises are another important component of CBT used for treating anxiety disorders like social anxiety disorder. Relaxation exercises include grounding exercises, breathing techniques, and muscle relaxation. Relaxation training can be combined with other therapeutic approaches like exposure therapy. The combination of these two techniques is used in systematic desensitization, which works by learning to associate feared social situations with relaxation.

Does CBT therapy help with social anxiety?

Cognitive-behavioral therapy is one of the most effective types of therapy for social anxiety disorder. This treatment can be used to change the negative thoughts that contribute to anxiety, help you learn new coping strategies, and gradually decrease the fear you experience in social situations

How many sessions of CBT are needed for social anxiety?

A minimum of 24 sessions of CBT therapy may be needed to treat a presentation of severe anxiety. Some individuals may recover more quickly, while others may require 48 or more CBT sessions combined with additional therapies to ensure that underlying root causes of anxiety are tackled.

Will social anxiety ever go away?

For some people, it gets better as they get older. But for many people, it does not go away on its own without treatment. It’s important to get help if you are having symptoms. Some treatments can help you manage it.

How can I calm my social anxiety at the moment?

Following are some helpful tips to deal with social anxiety

  • Control and regulate your breathing through breathing exercises
  • Try to exercise and do Progressive Muscle Relaxation.
  • Prepare in advance for such occasions
  • Take small steps to ease yourself in the situation
  • Take the Focus Off Yourself
  • Dispute Negative thoughts and Replace them with positive thoughts
  • Use Your Senses

What does social anxiety feel like?

Social anxiety is an extreme fear of social situations. It is an overwhelming feeling that can sometimes even result in the person suffering from panic attacks. A person suffering from SAD (Social anxiety disorder) often displays a behavior that is mostly misconstrued as shyness by the observers. They tend to blush, sweat, tremor,  have increased heart rate, and avoid eye contact. They can have physical symptoms such as stomach aches, nausea, or even fatigue. Their body and posture become stiff and they can have difficulty in speaking. The symptoms of SAD can differ from person to person but the overwhelming feeling of fear can be very debilitating.

References

Cuncic, A. (2020, September 23). How to crush your goals when you have sad. Verywell Mind. Retrieved December 20, 2021, from https://www.verywellmind.com/goal-setting-and-social-anxiety-disorder-3973936

MA, W. by: S. D., & MD, R. by: B. T. (n.d.). CBT for Social Anxiety: How It Works, Examples & Effectiveness. Choosing Therapy. Retrieved December 20, 2021, from https://www.choosingtherapy.com/cbt-for-social-anxiety/

NHS. (n.d.). NHS choices. Retrieved December 20, 2021, from https://www.nhs.uk/mental-health/conditions/social-anxiety/#:~:text=Social%20anxiety%20is%20more%20than,before%2C%20during%20and%20after%20them