Why Behavioral Therapy Alone Does Not Work For Social Anxiety

If simply “doing” things over and over again were enough to help us overcome social anxiety, then we would all have overcome it long ago.

Some questions: Do you still have anxiety about speaking to people even though you’ve done it dozens and dozens of times?

Are you still self conscious about speaking up in public … even though you’ve done it over and over again?

Do you still find it difficult to establish meaningful relationships, whether acquaintances, friends, or romantic?

Does the thought of talking to strangers and engaging in small talk still make you nervous? Haven’t you done this again and again for years and years?

We are constantly doing behavioral therapy with ourselves as we live through each day, unless we are totally avoidant. Many of us have done the things that cause us anxiety hundreds and hundreds of times…

….and we’re still anxious!

If behavioral therapy were all it took, we would have overcome this problem long ago.

Now, you can take a group of people with social anxiety, put them in a well-run behavioral group, and teach them to work slowly through each socially anxious event. If you do this, progress is very swift with this approach and people begin to do things very quickly.

The big problem here is that once the therapy program is over, it doesn’t take very long for the effects of this behavioral-only therapy to disappear. 

Why? Because a person’s thoughts (i.e., thinking patterns and beliefs) have not permanently changed.

Without having cognitive strategies, skills, and methods learned, a person does not have a new way to think and rationalize. Cognitive therapy changes the way we think and feel. It changes our beliefs and makes them more rational. 

Only cognitive therapy can do this. Behavioral therapy alone typically produces nothing of permanent value – it is only when the cognitive therapy is learned that the behavioral therapy can be put into place.

Both cognitive and behavioral must be put together (i.e., combined) for a permanent change to occur in our lives. The goal is to overcome social anxiety. We can do this with a comprehensive combination of cognitive and behavioral therapy that is specific to our social anxiety symptoms. 

In our programs at the Social Anxiety Institute, we combine the cognitive therapy with the behavioral therapy. We have a "safe" group environment, but when people are ready -- typically in a short time -- behavioral experiments are done outside the Institute at shopping malls, stores, university campuses, etc. 

Putting this all together may seem like a difficult process, but it is not. It is much easier to envision after you actually see it happen in one of our groups at SAI. 

Over the last ten years we have tested, retested, and tightened this all down for maximum effect in a limited amount of time. Thank you to all the researchers involved and especially to all the people with social anxiety that I have personally worked with in the last decade.