Online CBT for Social and Performance Anxiety

Cognitive Behavioural Therapy is a structured, practical but empathetic, approach that helps you identify and change unhelpful thought patterns and behaviours that contribute to your emotional difficulties. It focuses on the connection between thoughts, feelings, and behaviours. It is the most evidence based therapy available.

CBT is particularly effective for social anxiety by targeting the specific thought patterns and behaviours that maintain socical anxiety:

1. Identifying cognitive distortions: CBT helps you recognise common thinking errors in social anxiety such as mind-reading ("They think I'm boring"), catastrophising ("I'll completely humiliate myself"), and overgeneralising ("I always make a fool of myself").

2. Cognitive restructuring: You'll learn to challenge and replace anxiety-producing thoughts with more balanced perspectives based on evidence, not fears.

3. Exposure therapy: CBT includes gradual, structured exposure to feared social situations, allowing you to build confidence and collect evidence that contradicts your anxious predictions.

4. Reducing safety behaviours: The therapy helps identify and reduce avoidance tactics and safety behaviours (like excessive preparation or phone-checking) that actually maintain anxiety.

5. Attention training: CBT teaches techniques to shift focus away from internal monitoring ("How anxious do I look?") toward the actual social interaction.

6. Social skills development: If needed, CBT can incorporate practical skills training for conversation, assertiveness, and other social interactions.

7. Reducing post-event processing: The therapy addresses the tendency to ruminate about social interactions afterward, picking them apart and focusing on perceived failures.

8. Behavioural experiments: You'll design and conduct experiments to test anxious predictions in real-world situations, collecting data on what actually happens versus what you fear.

CBT's structured approach is particularly well-suited for social anxiety, as it provides concrete tools to interrupt the cycle of anxious thoughts, physical symptoms, and avoidance behaviours that sustain the difficulties, creating change at the root level instead of just managing symptoms.

CBT sessions typically last 50 minutes. This is the standard duration for most cognitive behavioural therapy appointments, providing enough time to review progress, discuss current challenges, learn and practice new techniques, and set homework assignments.

Most people attend weekly sessions, though this can vary based on individual needs and treatment phase. As therapy progresses and symptoms improve, sessions might become less frequent (biweekly or monthly).

The total number of sessions typically ranges from 8-20 for a full course of CBT treatment, though this depends on the specific condition being treated and your individual progress.

Many clients report feeling shifts after just 3-6 CBT sessions, though the number needed varies based on your history and the complexity of your anxiety. Some notice they're responding differently to social situations almost immediately, while more complex patterns may take longer to shift fully.

It's completely understandable that you're hesitant after trying CBT for social anxiety without success. Your experience is actually quite common, and there are a few important things to consider:

CBT for social anxiety should be highly specialised and structured. The most effective approach follows specific protocols developed at places like the University of Oxford, focusing on:

• Addressing the maintaining factors of social anxiety through a specific model (Clark & Wells model)

• Video feedback techniques to correct distorted self-image

• Attention training to shift focus outward instead of on yourself

• Behavioural experiments designed specifically to test social anxiety predictions

• Systematic work on reducing safety behaviours unique to social anxiety

Many clients tell me they've "tried CBT before" but when we explore further, they received more general therapy that incorporated some CBT concepts rather than the specialised protocol proven most effective for social anxiety. Sometimes it was too brief, lacked proper exposure elements, or didn't include key components like video feedback.

If you decide to try again with a therapist who specialises in evidence-based social anxiety treatment and follows these specific protocols, you might experience different results.

That said, if structured CBT still doesn't provide relief, we could consider EMDR (particularly if your social anxiety connects to specific past experiences) or an integrated approach combining elements of both treatments. Some people respond better to one approach than another, and sometimes a combination works best.

The key is finding a therapist who truly specialises in social anxiety treatment specifically, rather than generalised anxiety treatment.

Absolutely. CBT is particularly effective for performance anxiety, as it can target specific triggering scenarios. Many clients find significant relief for public speaking, performance, or workplace anxiety through targeted CBT sessions.

Absolutely! CBT (Cognitive Behavioural Therapy) and EMDR work excellently together and can create a comprehensive approach to treating social anxiety. While they work through different mechanisms, they complement each other well. CBT helps you recognise and challenge unhelpful thought patterns and develop practical strategies, while EMDR addresses the underlying emotional experiences and beliefs that fuel your anxiety at their source. Many clients find this combination particularly powerful.