Clinical Counseling and Social Anxiety

Anxiety is a normal emotional reaction that we all have to stressful situations. Sometimes anxiety and nervousness helps us realize what we find to be important. For example, anxiety could manifest right before a big presentation, showing that you truly care about the result. But, sometimes anxiety surpasses the normal amount and can severely impair a person’s ability to function at work, school and in social situations. Anxiety can also interfere with a person’s relationships with family members and friends (Sauer-Zavala, Bufka, and Wright, 2016).

Social anxiety also can greatly influence a person’s day to day life. It effects their ability to function in public, where possible crowds or just the presence of other people can cause debilitating anxiety. I personally have a coworker who struggles with social anxiety, and it greatly affects her ability to participate in every day life experiences. She’s had to cancel events and adjust her schedules due to the overwhelming anxiety she feels in social situations. Social anxiety disorder also has a low natural recovery rate (only 37% over 12 years) compared with major depressive disorder and other anxiety disorders. Thus, effective and accessible treatments for SAD are in high demand by both patients and health care organizations (Yoshinaga et. al, 2016). There are many counseling practices that are used to help treat social anxiety, and cognitive behavioral therapy seems to be one the most effective treatments.

Cognitive behavioral therapy is typically conceptualized as a short-term, skills-focused treatment aimed at altering maladaptive emotional responses by changing the patient’s thoughts, behaviors, or both. It focuses on changing cognitions, which is proposed to change emotions and behaviors.  Exposure-based techniques are some of the most commonly used Cognitive Behavioral Therapy methods used in treating anxiety disorders. Exposure is proposed to modify the pathological fear structure by first activating it and then providing new information that disconfirms the pathological, unrealistic associations in the structures. By confronting the feared stimulus or responses and integrating corrective information in the fear memory, fear is expected to decrease (Kaczkurkin, Foa, 2015).

For example, a large part of my coworker’s social anxiety are stores, especially grocery stores. When entering the store, it creates intense fear, followed by physical symptoms that become too overwhelming for her to continue. To help this with cognitive behavioral therapy, the exposure would involve a gradual approach to places, objects, people, or situations that were previously avoided although they are safe. So, a therapist would gradually approach the concept of a grocery store, attempt to adjust the perception of the store, and then approach the exposure-based technique. It is a way for the patient to acquire learning to self-modify the fear-structure (Kaczkurkin, Foa, 2015).

Clinical counseling is extremely beneficial in helping disorders of both the body and the mind. Anxiety and stress can have implications on the body, and counseling can help mitigate those stressors. Those with social anxiety seeking help with counseling, and possibly cognitive behavioral therapy, can get help with identifying the cognitive-social culprits involved in the onset of perpetuation of symptoms of social anxiety (Schneider, Gruman, Coutts, 2012). And with time, the counseling can greatly benefit someone to live their best life.

References:

Ellard, K. K., & Chronopoulos, A. (2016). Cognitive Behavioral Therapy for Anxiety Disorders. The Massachusetts General Hospital Handbook of Cognitive Behavioral Therapy,43-61. doi:10.1007/978-1-4939-2605-3_5
Sauer-Zavala, S., PhD, Bufka, L., PhD, & Wright, V., PhD. (n.d.). Beyond Worry: How Psychologists Help With Anxiety Disorders. Retrieved from http://www.apa.org/helpcenter/anxiety.aspx
Yoshinaga, N., Matsuki, S., Niitsu, T., Sato, Y., Tanaka, M., Ibuki, H., . . . Shimizu, E. (2016). Cognitive Behavioral Therapy for Patients with Social Anxiety Disorder Who Remain Symptomatic following Antidepressant Treatment: A Randomized, Assessor-Blinded, Controlled Trial. Psychotherapy and Psychosomatics,85(4), 208-217. doi:10.1159/000444221

1 comment

  1. My son is eleven and sometimes I feel like he struggles from a bit of social anxiety. I see it at times when I take him to places or events where there are other people. Even if he knows who the other people are, such as with family or with his friends from school. Your description of cognitive behavioral therapy “typically conceptualized as a short-term, skills-focused treatment aimed at altering maladaptive emotional responses by changing the patient’s thoughts, behaviors, or both” seems like it would be a good option for my son. When I ask him questions about what he is feeling he will usually shut down entirely or say he worries about people looking or talking to him. Also, your statistic on the number of instances in which social anxiety is naturally recovered from (the low 32%) definitely has me thinking I should seek some help for my son sooner than later!

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