Struggling With Social Anxiety Disorder: Group Therapy For Better Mental Health

Social anxiety can manifest in various common forms and is not necessarily being unable to leave your home and interact with others. In fact, social anxiety can be mild, with a person who prefers to be alone or needs some alone time but does reasonably well in a group setting. Engaging in treatment options like exposure therapy or social anxiety groups may help alleviate symptoms and build confidence in maintaining eye contact and conversations with most people.

What is social anxiety disorder?

Clinical medicine defines social anxiety (or social phobia) as an intense and persistent fear of being judged or negatively evaluated by others. This fear may lead to feelings of inadequacy, inferiority, embarrassment, humiliation, or self-consciousness. 

Some people with social anxiety disorder will also experience depression. These feelings and the behaviors that go along with them can occur to varying degrees and can interfere with life in different ways. Social anxiety disorder occurs when these feelings start to become overwhelming, or the individual reaches a level where they are irrationally anxious in social situations. Talking with a licensed mental health professional like a counselor or psychologist can help you determine whether you may be experiencing social anxiety disorder.

Who has social anxiety disorder?

Social anxiety disorders are considered one of the most common of all anxiety disorders with a prevalence rate of 7%.

Specific vs. generalized social anxiety disorder

Social anxiety is typically described as either specific (also known as limited or discrete) or generalized. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies specific and generalized social anxiety disorders in the same diagnostic category, but there are some qualitative differences between both.

In people with specific social anxiety disorders, their fear arises from distinct situations where they struggle with engaging positively with others socially. For example, a person may be able to engage in conversation without anxiety in most social situations unless they are asked to speak at a business meeting or talk about themselves personally. 

Generalized social anxiety disorder is characterized by an individual experiencing anxiety with all forms of social situations. They may feel anxious, worried, indecisive, depressed, inferior, or embarrassed when thinking about different real-life situations where they may have to interact with others, such as group participants or a family. In general, this form of anxiety is marked by consistent and intense anxiety that remains for an extended period. The situations that could affect someone and the symptoms they may experience can vary a great deal from one individual to the next.

Situations that may cause anxiety

For most people with social anxiety disorder, engaging in conversations or being around others may trigger anxiety and its symptoms. The most common forms of social interactions that can cause distress include:

• Being introduced to someone new

• Avoiding small talk or casual social settings

• Being at the center of attention or having to give a presentation

• Experiencing social encounters

• Being watched while they engage in an activity

• Forming or carrying on interpersonal relationships

• Anticipating job interviews

• Being teased or otherwise criticized

Each kind of feared situation mentioned (among others) may cause someone with social anxiety to feel afraid and exhibit behaviors such as avoiding eye contact or an inability to maintain a conversation. These social interactions may also cause physiological effects and intense emotional distress as they struggle to relate to others.

Physiological effects of social anxiety disorder on mental health

The physiological effects of social anxiety disorder can occur in any combination and severity level. Individuals dealing with social anxiety may experience a racing heartbeat, intense fear, blushing, excessive sweating, dry mouth, trembling, difficulty swallowing, and twitching. In some cases, the fear of showing these signs when in a social setting will trigger social anxiety. Each person experiences the physiological effects of anxiety symptoms differently. This means that it is important for you to pay attention to what your own body is telling you and identify if you are experiencing symptoms of social anxiety disorder. In general, these types of symptoms do not go away on their own but require therapeutic support.

Group therapy for social anxiety disorder: Learning social skills

While the idea of joining group sessions may be intimidating for someone with social anxiety disorder, it allows them to face their fears in a safe, non-judgmental environment.

Therapy groups offer core benefits, such as the opportunity for participants to engage in role-playing, learn to maintain eye contact with other group participants, and practice social skills before confronting feared situations in their everyday lives. Cognitive behavioral group therapy, for example, is an evidence-based treatment that helps people living with social anxiety learn social skills in a supportive environment. 

Learning through cognitive behavioral therapy for social anxiety

In cognitive-behavioral therapy (CBT), clients can learn the connections between their thoughts, feelings, and behaviors. Cognitive-behavioral group therapy takes both a cognitive and behavioral approach, allowing people to partake in cognitive therapy exercises and behavioral techniques to reduce social anxiety symptoms in a social anxiety group of peers. 

Elements of group psychotherapy for social anxiety

But what is group therapy all about? Group therapy places a person in a room with others experiencing a similar situation. In these cases, an individual feels comfortable in knowing that other people in the room can understand the challenges of social anxiety. Group therapy for social anxiety disorder incorporates several different techniques, such as:

Exposure work 

Exposure work is a cognitive-behavioral technique that involves gradually exposing an individual to feared thoughts, feelings, and/or situations, which can decrease anxiety levels over time in a process called habituation. In group therapy, exposure may be done through role play, where other people in the group simulate an anxiety-producing situation, such as asking someone on a date or having a group of people sing “Happy Birthday” in public. This technique can be effective in a cognitive-behavioral group because the group format can allow groups to face their social fears while also being around others who understand social anxiety. 

Cognitive restructuring

This technique for therapy groups focuses on challenging unhelpful thought patterns that may be contributing to anxiety and adopting new ways of perceiving situations.

Homework assignments

Groups may be asked to engage in exposures in between sessions and reflect on what they learned.

Group psychotherapy for social anxiety is intended to be a supportive environment for people who are looking for ways to reduce anxiety symptoms, learn how to overcome their fears, and feel comfortable in their daily lives. Each person in cognitive behavioral group therapy has goals similar to yours and is looking for solutions.

Getting the help you need with social anxiety group therapy

When seeking professional help, choose a therapist who understands social anxiety disorder and will provide you with strategies to reduce your anxiety while building social skills. A therapist who has worked directly with people with social anxiety disorder has the experience needed to provide appropriate feedback and advisement to help you make progress. Ideally, you will want to find someone who specializes in anxiety disorders.

Cognitive behavioral therapy and online options

You may also want to interview therapists who practice cognitive behavioral therapy treatment entirely online rather than one who will only practice in a traditional setting or a local group. Online therapy allows you to remain in a place where you are most comfortable: your own home. Your home is a safe environment with which you are very familiar. From there, it also allows you to schedule and attend treatment sessions easily to fit better with your life.

Also, like group therapy, online therapy tends to be more affordable than traditional, one-on-one sessions at a physical location. Therefore, if you have social anxiety, cognitive behavioral group therapy and online therapy are both extremely effective solutions for those who want assistance but at a more approachable price range. For example, a study showed the efficacy of online therapy for people who have social anxiety. Within a span of 12 sessions and a 3-month follow up, 24 participants found significant improvement in their social anxiety. Online individual therapy was also proven to be beneficial for people with depression, disabilities, and quality of life issues.

Mental health insights

Lastly, you could also investigate support groups. Keep in mind this is not the same as group therapy treatment and may not be led by a licensed professional. A support group for social anxiety may have the same types of goals as group therapy with people living with a similar experience. When participating in a support group, people learn from one another and can give each other feedback by asking and answering common questions. While some people can still make progress, it is not the same as getting professional advice, treatment, and feedback from mental health counselors or therapists who are trained to help clients move past social anxiety.

How BetterHelp can support you and your mental health

BetterHelp is a resource to help you find the support you need. You have the opportunity to find someone with whom you feel comfortable. Meeting in person can present a challenge for many people with social anxiety disorder, especially when you are trying to manage stress and alleviate symptoms. Fortunately, there is social anxiety online therapy available for those who have this disorder. If group therapy is not for you, then individual therapy is an appropriate option. Working with one of BetterHelp’s professionals can help you develop strategies to improve the quality of your life, free from the restrictions of social anxiety and its impact on your self-expression. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.