Social Anxiety

Social anxiety is an intense fear of being judged, embarrassed, or negatively evaluated in social or performance situations — strong enough that you avoid, endure with dread, or replay it for hours afterward.

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How it can show up

  • Fear of saying the wrong thing, blushing, shaking, or “looking anxious”
  • Avoiding speaking up, meetings, dating, or social events
  • Replaying conversations afterward, scanning for mistakes
  • Relying on safety behaviours — rehearsing, over-preparing, staying quiet
  • Intense self-focus and self-monitoring in the moment

What is social anxiety?

Social anxiety disorder (social phobia) is a marked, persistent fear of social or performance situations in which you might be scrutinized. It’s far more than shyness — it can shrink your world, holding you back at work, in relationships, and in everyday interactions.

What keeps social anxiety going?

The influential Clark & Wells (1995) cognitive model explains the trap: in feared situations, attention turns inward onto how you think you’re coming across, “safety behaviours” (rehearsing, avoiding eye contact, gripping a glass) prevent you from learning you’re okay, and anticipatory and post-event rumination keep the fear alive. Rapee & Heimberg’s model adds how we over-estimate the standard others hold us to and the cost of falling short.

How therapy helps

Clinical guidelines recommend individual CBT based on the Clark & Wells model as a first-line treatment for social anxiety. Together we shift attention outward, drop safety behaviours, and use behavioural experiments and graded exposure to test feared predictions in real situations — so your confidence is built on evidence, not avoidance.

How the Unified Protocol helps with social anxiety

Social anxiety disorder (SOC) was a principal diagnosis group in the NIMH-funded equivalence trial (Barlow et al., 2017), the most rigorous test of the UP to date. The UP produced outcomes equivalent to gold-standard CBT for social anxiety at both post-treatment and six-month follow-up, with notably lower dropout. The trial confirmed the UP as a credible, transdiagnostic alternative to disorder-specific social anxiety protocols.

"Susan" in Barlow & Farchione (2018) illustrates how the UP works with social anxiety. She feared job interviews, speaking up, and meeting strangers, and relied on over-preparation and reassurance as safety strategies. The UP helped her shift attention outward, drop safety behaviours, and face social situations directly. By the end of 16 sessions her social anxiety CSR had fallen from 4 to below clinical threshold.

Case example from Barlow & Farchione (2018) — Applications of the Unified Protocol

The UP is particularly well-suited for social anxiety that travels alongside perfectionism, self-criticism, or low mood. Rather than running separate treatments for each concern, a single UP course addresses the common emotional sensitivity and avoidance patterns underneath all of them.

  • Emotion exposures in the UP naturally span social situations and other feared contexts, addressing the full anxiety profile
  • Safety behaviours and self-focused attention are targeted through the CEB (countering emotional behaviours) module
  • Shame and self-judgment, which drive post-event rumination in social anxiety, are directly addressed through mindful emotion awareness

For younger clients: The UP for Adolescents (UP-A; Ehrenreich-May et al., 2017) applies the same framework adapted for teenagers. Open trials and a randomized pilot study have shown significant reductions in social anxiety and depression in adolescent samples, with gains maintained at follow-up.

Frequently asked questions

What is the best treatment for social anxiety?

Individual Cognitive Behavioural Therapy based on the Clark & Wells model — combining attention-shifting, dropping safety behaviours, and graded exposure — is recommended by clinical guidelines as a first-line treatment for social anxiety disorder.

Is social anxiety just shyness?

No. Shyness is a temperament; social anxiety disorder is a more intense, persistent fear of judgment that causes real distress and avoidance and interferes with work, relationships, or daily life.

Does exposure for social anxiety mean being thrown into scary situations?

No. Exposure is graded and collaborative — we plan each step together and you control the pace. The aim is to test feared predictions gradually, not to overwhelm you.

Free self-help resources

Evidence-based CBT workbooks from the Centre for Clinical Interventions (Government of Western Australia) — a helpful complement to therapy you can start on your own:

Selected clinical references

The approach to this concern is informed by established clinical models and treatment guidelines, including:

  1. Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia.
  2. Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia.
  3. NICE (2013). Social anxiety disorder: recognition, assessment and treatment (CG159).
  4. Farchione, T. J., et al. (2012). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: A Randomized Controlled Trial. Behavior Therapy, 43(3), 666–678.
  5. Barlow, D. H., et al. (2017). A unified protocol for transdiagnostic treatment of emotional disorders: A randomized controlled trial. JAMA Psychiatry, 74(9), 875-884.
  6. Barlow, D. H., & Farchione, T. J. (Eds.). (2018). Applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Oxford University Press.
  7. Ehrenreich-May, J., et al. (2017). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents: Therapist Guide. Oxford University Press.