Cognitive behavioral therapy (CBT) is a highly effective treatment for social anxiety in children, teens, and adults.1 This short-term therapy helps individuals to identify and challenge the negative thoughts that contribute to their social anxiety. During CBT sessions, the therapist helps their client to build confidence, improve social skills, and gradually confront the social situations they fear. These strategies are essential for overcoming challenges associated with social anxiety, such as fearing judgment, excessive self-criticism, and struggling to form relationships.
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Can CBT Help With Social Anxiety?
Cognitive behavioral therapy (CBT) is one of the most well-researched and effective treatments for social anxiety. It focuses on changing the negative thoughts and behaviors that fuel anxiety in social situations. Research has consistently shown that CBT is highly practical and results-oriented, helping many people reduce their symptoms of social anxiety.1
- A study found that after 12 CBT sessions, participants showed significant improvement in social anxiety symptoms compared to those receiving ACT (Acceptance and Commitment Therapy).2
- Another study demonstrated that CBT helped decrease the negative self-beliefs commonly seen in people with social anxiety, leading to a reduction in symptom severity over 12 weeks.3
- Group CBT has been effective in reducing symptoms of social anxiety and depression, even in individuals with co-occurring social anxiety disorder (SAD) and psychosis.4
How CBT Overcomes Social Anxiety
Social anxiety often stems from an exaggerated fear of judgment or embarrassment in social situations. CBT helps you understand how these anxious thoughts lead to avoidance behaviors and increased discomfort. By recognizing and addressing the thought patterns that drive your anxiety—such as assuming you’ll embarrass yourself or believing others are constantly judging you—CBT guides you toward healthier, more realistic thinking. This understanding is crucial in breaking the cycle of fear, avoidance, and negative beliefs that sustain social anxiety.
Here is how CBT can help you overcome social anxiety:
1. Understanding the Problem
Psychoeducation is an essential part of CBT, where the therapist helps you understand your social anxiety symptoms and how the treatment can address them. When you have social anxiety, your mind tends to focus on the worst possible outcomes in social situations. For example, you might think, “I’ll say something embarrassing during the meeting,” or “People will think I’m awkward at the party.” These thoughts trigger feelings of anxiety, and in turn, you might avoid social situations altogether.5
When you shift your unrealistic, negative thinking, like “Everyone will notice if I stumble over my words,” and replace it with more balanced thoughts, such as “Most people won’t remember small mistakes,” your behaviors will shift too. Instead of avoiding social situations, you start facing them gradually, building up from smaller, less intimidating events to more challenging ones. Over time, as you challenge your fears and experience more positive social outcomes, your anxiety decreases, and your confidence grows.
2. Cognitive Restructuring
In CBT, the first step is helping you become aware of the negative thoughts that trigger your social anxiety.
Once you’re aware of these unhelpful thoughts, CBT helps you challenge them through a process known as cognitive restructuring.6 Your therapist will guide you through questions like:
- Is this thought realistic?
- What evidence do I have that people are actually judging me?
- Have I been in social situations where nothing bad happened?
By analyzing these thoughts in a more balanced way, you start to realize that your fears may not be as true or likely as they feel in the moment.
After challenging your negative thoughts, the next step in CBT is replacing them with healthier, more balanced thinking. Instead of thinking, “Everyone will think I’m awkward,” you might replace it with, “Even if I’m nervous, most people won’t notice, and it’s okay to make mistakes.” This shift in thinking reduces the intensity of your anxiety because you’re not jumping to worst-case scenarios. Over time, you start feeling more confident in social settings.
Example of Cognitive Restructuring
Max was invited to a concert with a friend but felt hesitant due to the large and loud crowds typical of this band’s shows. Cognitive restructuring can help Max identify his unhelpful thought, such as the fear of being around or talking to strangers, and replace it with a more balanced thought, like “These are strangers I will likely never see again, and the situation will be over soon.” This process not only reduces anxiety but can also help Max shift his focus from the discomfort of the situation to the potential reward of enjoying the concert.
3. Exposure Therapy
Another key part of CBT for social anxiety is gradually facing your fears through exposure therapy. This means slowly putting yourself in social situations that you would normally avoid. Your therapist will help you start with less challenging situations and build up to more difficult ones. For example, you might start by briefly asking a stranger for directions in a park, and as you gain more comfort, work your way up to participating in a group discussion at a social event. By facing your fears in a controlled and supportive way, you begin to see that the outcomes aren’t as bad as you expected. Over time, this reduces your anxiety and builds your confidence in social interactions.7
Exposures for social anxiety can either be:
- In vivo exposure: This involves facing real-life social situations that trigger anxiety. For example, if you’re nervous about going to a party, your therapist may help you gradually attend small gatherings until you feel more comfortable in larger social settings.
- Imaginal exposure: In cases where facing a real-life situation feels overwhelming, you start by imagining the anxiety-provoking scenario in vivid detail. For instance, you might visualize having a conversation with a group of new people, allowing yourself to process the feelings in a safe environment.
Example of Exposure Therapy
Max, who was invited to a concert, could use exposure therapy to help manage his social anxiety. With the guidance of a therapist, Max might start by imagining himself in small social gatherings. As he becomes more comfortable with these imagined scenarios, he gradually progresses to being around small groups of people in real life, eventually working up to attending larger crowds like the concert. This step-by-step approach allows Max to face his fears in a manageable way, with the key being regular practice until he feels more comfortable and less anxious in these situations.
Social Skills Training
People with social anxiety often feel like they lack certain social skills, which can make them even more anxious in social situations. CBT helps you develop skills like assertiveness and effective communication, so you can interact with others in a more confident and relaxed way. For instance, you may practice how to make eye contact or how to express your thoughts clearly. Developing these skills helps you feel more prepared and comfortable in social situations, which naturally reduces anxiety over time.8
Example of Social Skills Training
Greg feels anxious about joining group conversations at work because he worries about saying the wrong thing or being awkward. In social skills training, Greg might start by working with his therapist to practice introducing himself and joining a conversation. They could role-play different scenarios where Greg introduces a topic or asks a question to engage others. As Greg gets more comfortable, he could then practice these skills in real-life situations, like starting a brief conversation with a coworker during a break. Over time, as he continues practicing and building confidence, Greg can move on to more complex situations, such as contributing to group discussions during meetings.
4. Mindfulness & Relaxation Exercises
CBT also teaches you practical coping strategies for managing anxiety in the moment. One effective technique is mindfulness for anxiety, which involves focusing your attention on the present moment without judgment. By being fully engaged in what’s happening now, you can reduce worries about past or future social interactions. Your therapist will also teach you relaxation exercises, such as breathing techniques or progressive muscle relaxation to calm your body before or during a social situation. These tools help you stay grounded and in control, even when anxiety flares up.
Example of Social Skills Training
Greg feels anxious about joining group conversations at work because he worries about saying the wrong thing or being awkward. In social skills training, Greg might start by working with his therapist to practice introducing himself and joining a conversation. They could role-play different scenarios where Greg introduces a topic or asks a question to engage others. As Greg gets more comfortable, he could then practice these skills in real-life situations, like starting a brief conversation with a coworker during a break. Over time, as he continues practicing and building confidence, Greg can move on to more complex situations, such as contributing to group discussions during meetings.
How Long Does CBT Take to Treat Social Anxiety?
The length of time CBT takes to treat social anxiety varies from person to person, depending on the severity of symptoms and any other underlying mental health concerns. Typically, CBT treatment lasts for 10 to 20 weekly sessions, with each session lasting about an hour. However, the time it takes to see results can differ, especially if there are other factors, such as trauma or co-occurring mental health conditions, that need to be addressed. It’s important to approach the process with an open mind and trust that, with your therapist’s support, you can work through the challenges and make meaningful progress.
Examples of CBT for Social Anxiety
Trouble Conducting Meetings at Work
Steve, a 46-year-old who was recently promoted, now has the responsibility of conducting weekly staff meetings at work. While he excels in his job, he has always had a fear of public speaking. He worries about making mistakes and being seen as incompetent by his colleagues. Before his first meeting, Steve experienced a rapid heart rate, heavy breathing, nausea, and trouble concentrating—symptoms that led him to visit the emergency room, where he learned he’d had a panic attack. The doctor referred him to a CBT therapist to explore what triggered the attack and to develop coping strategies. Steve’s panic attack was related to underlying social anxiety, and alongside CBT techniques like relaxation exercises, he can use exposure therapy to gradually ease his fear of public speaking.
Adjusting to College Life & Making New Friends
Sara, an 18-year-old freshman, is adjusting to her first semester of college far from home. Naturally shy, she struggles to make new friends and feels uncomfortable in group projects or social situations, convinced that others are judging her. Her anxiety became so overwhelming that she began skipping classes, which impacted her grades. Feeling isolated, she confided in her mother, who encouraged her to seek help from the university’s counseling center. Sara’s social anxiety makes it hard for her to engage with others, but working with a CBT therapist can help her challenge her irrational fears of being rejected, allowing her to build more confidence in social situations.
Trouble in a Classroom Setting
Abby, a bright 7-year-old first grader, is doing well academically, but her teacher expressed concerns about her social interactions during a parent-teacher conference. Abby avoids reading aloud in class, hides during show-and-tell, and prefers playing alone at recess rather than interacting with her classmates. Her teacher suggested therapy to help Abby with her social development. A CBT therapist specializing in children can help Abby understand how her thoughts and emotions influence her behavior. Through exposure therapy and relaxation techniques, Abby can learn to manage her anxiety and gradually feel more comfortable engaging in social activities with her peers.
CBT Therapy Options
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How to Find a CBT for Social Anxiety Therapist
Finding a CBT therapist to help with social anxiety can be a straightforward process with the right tools. One of the best ways to start is by using an online therapist directory, which allows you to narrow your search based on your location, the type of therapy offered, and other important factors, such as the therapist’s specialty or availability. Additionally, if in-person sessions aren’t convenient, many online therapy services offer CBT, making it easier to find a therapist who specializes in social anxiety from the comfort of your home. Services like Online-Therapy.com can connect you with trained CBT professionals.
When choosing a CBT provider, it’s important to ask about their specific training in CBT, how long they’ve been practicing this approach, and their experience treating social anxiety. All licensed CBT therapists should have the necessary credentials to provide this therapy.
Find a Supportive Therapist Who Specializes in CBT.
BetterHelp has over 30,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $65 per week and is FSA/HSA eligible by most providers. Take a free online assessment and get matched with the right therapist for you.
At-Home CBT Exercises for Social Anxiety
There are several CBT exercises you can do at home to help manage social anxiety. Like learning any new skill, they may feel awkward or uncomfortable at first, but with consistent practice, these techniques can become highly effective in reducing anxiety. Additionally, using CBT apps can make practicing at-home exercises even easier.
Here are some at-home CBT exercises that can help with your social anxiety:
- Thought records: Write down a situation that triggers your social anxiety, the negative thoughts you have in that moment, and the emotions that arise. Then, challenge those thoughts by questioning their accuracy (e.g., “Is this really true?” or “What evidence do I have that people are judging me?”). Replace the negative thought with a more balanced one.
- Deep breathing: There is an abundance of simple deep breathing exercises that can be performed at home. For example, focus on breathing slowly, counting to 4 as you inhale, holding for 7 seconds, and then exhaling for 8 seconds. Practice this 4-7-8 breathing for 5-10 minutes at a time. This helps calm the body and mind before or during social situations.
- Mindfulness meditation: Mindfulness and meditation for anxiety can help you stay grounded and reduce overthinking in social settings. Spend a few minutes each day practicing mindfulness by focusing on the present moment, whether you’re walking, eating, or just sitting quietly. This can reduce anxious thoughts about what others are thinking.
- Grounding techniques: Use a grounding techniques for anxiety to keep your focus on the here and now in social situations by seeking out sensory stimuli in your current environment. To do a simple grounding exercise, focus on finding 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, 1 thing you can taste.
Frequently Asked Questions
Can CBT Work Online?
Yes, online CBT can be highly effective for treating social anxiety disorder. Since social anxiety often involves discomfort in new environments and around unfamiliar people, online therapy offers a way to engage in treatment from the comfort and security of your own home. In fact, a meta-analysis comparing in-person CBT with online CBT found that online therapy had a significant impact on reducing social anxiety, showing that it can be just as effective as in-person sessions. With the convenience of teletherapy, individuals struggling with social anxiety can get the help they need in a more flexible and comfortable way.9
How Much Does CBT Cost?
The cost of CBT can vary based on several factors, including your location, the therapist’s credentials, and your insurance coverage. Many insurance plans cover mental health services, including CBT, but there is often a copay, which can range from as little as $10 to over $100, depending on your plan and whether the provider is in-network. Opting for an in-network therapist can help lower out-of-pocket costs, making the copay more affordable.
If you choose an out-of-network provider or a therapist who doesn’t accept insurance, session fees can range from $80 to $450. However, some therapists may offer a sliding scale, adjusting their rates based on your income or financial situation.
Can CBT Be Combined With Medication for Anxiety?
Yes, CBT can be effectively combined with medication to treat anxiety. While CBT focuses on helping you change negative thought patterns and behaviors, medication can help reduce the physical symptoms of anxiety, such as rapid heart rate or constant worry, making it easier to engage fully in therapy. For some people, combining both approaches provides faster and more comprehensive relief.10
CBT for Social Anxiety Infographics
Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC:Author.
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Herbert, J. D., Forman, E. M., Kaye, J. L., Gershkovich, M., Goetter, E., Yuen, E. K., … & Marando-Blanck, S. (2018). Randomized controlled trial of acceptance and commitment therapy versus traditional cognitive behavior therapy for social anxiety disorder: Symptomatic and behavioral outcomes. Journal of Contextual Behavioral Science, 9, 88-96. https://doi.org/10.1016/j.jcbs.2018.07.003
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Guo, S., Deng, W., Wang, H., Liu, J., Liu, X., Yang, X., … & Li, X. (2021). The efficacy of internet-based cognitive behavioural therapy for social anxiety disorder: A systematic review and meta-analysis. Clinical Psychology & Psychotherapy, 28(3), 656-668. https://doi.org/10.1002/cpp.2525
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Michail, M., Birchwood, M., & Tait, L. (2017). Systematic review of cognitive-behavioural therapy for social anxiety disorder in psychosis. Brain Sciences, 7(5), 45. https://doi.org/10.3390/brainsci7050045
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Moorey, S., & Lavender, A. (2019). The therapeutic relationship in cognitive behavioural therapy. Sage. https://doi.org/10.4135/9781526461568
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Curtiss, J. E., Levine, D. S., Ander, I., & Baker, A. W. (2021). Cognitive-Behavioral Treatments for Anxiety and Stress-Related Disorders. Focus (American Psychiatric Publishing), 19(2), 184–189. https://doi.org/10.1176/appi.focus.20200045
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American Psychological Association. (2017). What is exposure therapy? https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy
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Dobson, K. S., & Dozois, D. J. A. (Eds.). (2019). Handbook of cognitive-behavioral therapies (4th ed.). Guilford Press.
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Osborne, D., Meyer, D., Moulding, R., Kyrios, M., Bailey, E., & Nedeljkovic, M. (2019). Cost-effectiveness of internet-based cognitive-behavioural therapy for obsessive-compulsive disorder. Internet Interventions, 18, 100277. https://doi.org/10.1016/j.invent.2019.100277
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Crits-Christoph, P., Newman, M. G., Rickels, K., Gallop, R., Gibbons, M. B. C., Hamilton, J. L., Ring-Kurtz, S., & Pastva, A. M. (2011). Combined medication and cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 25(8), 1087–1094. https://doi.org/10.1016/j.janxdis.2011.07.007
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: Sidney Deupree, MA, LPC, NCC (No Change)
Reviewer: Benjamin Troy, MD (No Change)
Primary Changes: Fact-checked and edited for improved readability and clarity.
Author: Sidney Deupree, MA, LPC, NCC (No Change)
Reviewer: Benjamin Troy, MD (No Change)
Primary Changes: Added sections titled “Psychoeducation” and “Assertiveness & Problem-Solving.” New content was written by Lydia Antonatos, LMHC, and medically reviewed by Kristen Fuller, MD. Fact-checked and edited for improved readability and clarity.
Author: Sidney Deupree, MA, LPC, NCC (No Change)
Reviewer: Benjamin Troy, MD (No Change)
Primary Changes: Added sections titled “How Long Does CBT Take to Treat Social Anxiety?,” “Can CBT Work Online?” and “How Much Does CBT Cost?” Revised section titled “Common CBT Exercises for Social Anxiety Disorder.” New content was medically reviewed by Dena Westphalen, PharmD. Fact-checked and edited for improved readability and clarity.
Author: Sidney Deupree, MA, LPC, NCC
Reviewer: Benjamin Troy, MD
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