Therapy for Social Anxiety Disorder (Social Phobia)
A qualified therapist can play an important part of treatment for social anxiety disorder (social phobia). Cognitive-behavioral therapy (CBT) has been shown to be the most effective treatment. While learning to become your own therapist is one of the primary goals of CBT, it is often most helpful to work through the therapy strategies with a qualified psychotherapist. These can include psychologists, psychiatrists, clinical social workers, licensed therapists, psychiatric nurses and other professionals as explained on our social anxiety disorder page.
Finding a Therapist
Finding the right therapist takes research, patience, and intuition.
If you have insurance, it is often best to search through your insurance's channels. Often, you can call the number on the back of your insurance card or search your insurance company's website using your zip code to locate a list of psychologists and therapists in your area. Depending on your insurance, you may need to ask for a referral from your primary care physician first.
If you are concerned about cost, take a look at the Anxiety Disorders Association of America's low-cost treatment page to learn about low-cost treatment options. Also, some therapists offer a "sliding scale" or reduced fee for those without insurance and limited financial resources.
If you don't have insurance or would like to search for therapists outside of your insurance's channels, there are a number of websites that have directories of therapists.
Start by making a list of five therapists located nearby using the resources discussed above. If possible with the channel you are searching through, specify therapists who are experienced with anxiety disorders and identify cognitive-behavioral therapy as a treatment style.
Then proceed to the Quesitons to Ask Potential Therapists section below to narrow the list down to only those who specialize or are experienced in treating social anxiety disorder.
Nervousness About Contacting Potential Therapists
You're not alone if you find making phone calls challenging. This is a common experience for people with social anxiety disorder.
Once you've found some potential therapists (see above section), it can be challenging to work up the courage to make the phone calls and ask the questions needed to find out which therapists are qualified.
First, remember that you've already taken very some important steps. You've learned about social anxiety disorder, recognized that you may be suffering from it, taken the initiative to do something about it, and found a list of potential therapists. You should be proud of yourself for making it this far.
On your first phone call you'll often be talking to the therapist's receptionist or voicemail and just providing your name, phone number and a good time to reach you.
Since you are going to calling at least a few therapists, it can be helpful to make a short script of what you are going to say to the therapists, including the questions we have listed in the below section.
If you find the thought of making the initial phone call too overwhelming, try looking for therapists that offer the option to communicate via email as a first step.
Questions to Ask Potential Therapists
We contacted a handful of therapists experienced with treating social anxiety disorder and asked them what questions they'd recommend asking potential therapists.
Go through the list of therapists you found (following the steps above) and ask them by phone or email the following questions:
- What percentage of your clients are being treated for social anxiety disorder?
Ideally, you'd find a therapist whose specialty is social anxiety disorder, but that's not always possible. Regardless, it's important to find out how much experience the therapist has treating social anxiety disorder. Be persistent contacting therapists until you find one who has specifically worked with social anxiety.
- What techniques do you use to treat social anxiety disorder?
Look for phrases like cognitive restructuring, systematic desensitization, exposure techniques, behavioral homework experiments, homework assignments, mindfulness practice, in-session role plays, etc.
- Do you give homework assignments?
Learning to become your own therapist is one of the primary goals of cognitive-behavioral therapy and the therapy is much more effective when practiced outside just the session with your therapist. Look for a therapist who'd ask that you do perform both cognitive and behavioral homework assignments between sessions.
- What percentage of your clients experience significant improvement and how do you measure that?
Ask for a rough "success rate" for their treatment of social anxiety disorder and, more importantly, how they determine this with their clients (e.g. Liebowitz Social Anxiety Scale).
- What special training have you received?
Do they have special training in cognitive-behavioral therapy (CBT)? Have they been trained specifically to diagnose and treat social anxiety disorder?
Don't get discouraged if none of the five therapists you contacted are experienced in treating social anxiety disorder. Finding a qualified therapist can take persistence. Return to the resources you used to find the first five therapists and look for five more. If possible with the channel you are searching through, specify therapists who are experienced with anxiety disorders and identify cognitive-behavioral therapy as a treatment style.
Deciding Which Therapist to Start Therapy With
The questions above will help you in finding a therapist that is knowledgeable about and experienced treating social anxiety disorder, but something that is just as important is your level of comfort with the therapist. For most people, and especially those with social anxiety, seeing a therapist can cause anxiety. However, you can find a therapist who's style, personality, age, sex, etc. fits you well and allows you to be as comfortable as you can be. How you feel in the presence of your therapist can influence success in therapy (there is research that supports this).
Start with the questions above to narrow down your initial list of therapists. Then, either by talking to them over the phone or preferably meeting with them in person, find the therapist that you are the most comfortable around. It is recommended that you talk to more than one before making a choice.
Talking About Your Symptoms
For some, it can be a challenge to express how they feel and what symptoms they are experiencing. For your first appointment, it can help to bring in a written list of your symptoms and the ways that they interfere with your daily life. Consult our social anxiety disorder article for common symptoms that you may be experiencing. If during that first appointment you have trouble sharing your symptoms, then it might be easier to read what you've written down or even just hand the list over to your therapist.
Emily Ford offers invaluable advice about this in her enlightening book What You Must Think of Me:
“This is a problem I have struggled with myself. I used to wonder a lot about what my therapist's other patients said and did, and I worried that my own words and actions might seem too odd or extreme by comparison. I often was tempted to recite the symptoms I thought I was supposed to have rather than describe the deeply personal and sometimes disturbing feelings I really was having.
These days, when I catch myself thinking that way, I remind myself that Dr. Q. isn't there to judge; she's there to listen and help. In order to help me effectively, she needs to have the straight facts. Chances are, she has already heard it all—or at least heard similar things—anyway. And contrary to my fears, Dr. Q. has never once seemed horrified or disgusted by anything I said.
Once you've confided something personal to your therapist, watch out for feelings of embarrassment that might make you want to avoid going back again. If such feelings do arise, remember that they're a reflection of your social anxiety, not a sign that you actually have anything to be embarrassed about. Second-guessing yourself is second nature when you have social anxiety. But as time goes on, you'll start to see that the more honest you are in therapy, the more benefit you gain.”