What is Social Anxiety?
Social anxiety, also known as social anxiety disorder (SAD), is a mental health condition characterised by an intense, persistent fear of being watched and judged by others. This fear can significantly interfere with daily activities, work, school, and relationships.
Symptoms of Social Anxiety
Social anxiety disorder can present with a range of symptoms:
- Physical symptoms: Rapid heartbeat, sweating, trembling, nausea, or difficulty speaking.
- Cognitive symptoms: Intense worry about social situations, fear of embarrassment, and negative self-perception.
- Behavioral symptoms: Avoidance of social situations, difficulty making eye contact, and staying quiet or hiding in social settings.
The condition can range from mild to severe, and it often begins in adolescence. It can be treated with therapy, medication, or both. Common therapeutic approaches include cognitive-behavioral therapy (CBT), exposure therapy and group therapy. Ultimately, treatments for social anxiety aim to improve an individual's social functioning and overall quality of life.
Treatments for Social Anxiety
One of the most challenging aspects of social anxiety disorder (SAD) is the thoughts that come with the experience. People struggling with social anxiety experience a barrage of negative self-judgments and the fear that others view them in that same negative light. Over time, these self-judgments lead to avoidant behaviours such as disengagement in social interactions, substance use to engage, or avoidance of social situations altogether. Numerous methods have been proposed around how to work effectively with the thoughts that come with social anxiety. One such approach, called Acceptance and Commitment Therapy (ACT) or “act”, is a well-researched and evidence-based practice with a proven track record of long-term sustainable results at long-term follow-up and a reduction in rates of relapse.
Acceptance and Commitment Therapy as a Treatment for Social Anxiety Disorder
ACT offers an empowering approach that puts the patient back in the driver’s seat to address social anxiety. Beyond symptom reduction, ACT provides practical tools and skills that pave the way to a more meaningful and fulfilling life. One of the fundamental benefits of ACT lies in its emphasis on acceptance. Rather than struggling against or suppressing anxious thoughts and emotions, individuals learn to acknowledge and accept them. This way, ACT directly addresses a common hurdle known as experiential avoidance – the tendency to evade or avoid uncomfortable emotions and situations at all costs -which is highly prevalent among people with social anxiety and often perpetuates social anxiety symptoms. By embracing the present moment through mindfulness practices, individuals develop a greater awareness of their thoughts and feelings. This heightened awareness fosters a sense of clarity and distance, enabling them to respond more skillfully to challenging situations. The result is reduced reactive behaviours and an increased ability to choose responses aligned with personal values.
ACT-Based Group Therapy for Social Anxiety
The program combines mindfulness training with ACT to help effectively manage social anxiety and social phobia. Our group sessions are effective and based on well researched and validated treatment protocol developed by psychologists Dr. Jan Fleming and Dr. Nancy Kocovski. By the end of the group, you will be able to overcome your anxiety so you can engage in the social activities that are meaningful and important to you. The benefits from the group will last long after the group is over. In our group sessions, you can learn and practice tools and techniques to help you overcome social anxiety. By the end of the group, you can be more open and willing to face your fears and be more successful in social situations.
People with social anxiety are often hesitant to join a group. We can reassure you that this group program is right for you because you are anxious about joining groups. The group format gives you a safe place to learn skills so you can overcome your social anxiety.
Treatment Plan for Social Anxiety Group Therapy
The class meets once a fortnight for 20 weeks for a total of 10 sessions. Each class is around 90 minutes long. The groups are designed for approximately 6-12 participants. A waitlist will be compiled for each 20-week program cycle, with the group running two times per year. An outline of the session is detailed below:
| Session |
Focus |
Summary |
| Session 1 Week 1 |
Introduction to Safety Mode and VITAL Action Mode. |
In the first week, the session begins with general administrative and housekeeping processes. An introduction to mindfulness is explored via mindful eating exercise (intake questionnaire to assess for any allergies). An overview of the six core processes of ACT are briefly explored followed by understanding of Social Anxiety Disorder. Maintaining factors are discussed through over reliance on use of safety behaviours, focus and attention on social threats and danger, overcontrol and resistance of anxious feelings, and getting fused/buying into anxious thoughts. |
| Session 2 Week 3 |
Acceptance and Willingness. |
This week introduces participants to perspective taking exercises through the use of The Observing Mountain metaphor, inviting participants to take note of different parts of their experiences such as thoughts, images, memories, emotions, and sensations. The rationale for Acceptance processes is introduced as to why we practice it. The use of the ‘Niagra Falls’ experiential exercises is used to demonstrate anxiety sensors. Participants are invited to consider their past experiences of ‘controlling anxiety’. |
| Session 3 Week 5 |
Values and Goals. |
Session 3 begins with a mindful body scan incorporating progressive muscle tension and release, noting the difference between those states. The Body Scan is the first “prong” of a three-pronged approach participants will learn in the group to help gradually build up a willingness to experience physical sensations of anxiety, or in other words to “strengthen your abs”: your acceptance of bodily sensations. This session also explores the rationale and myths around self-compassion. Self-compassionate imagery is also explored in the session. The practice is about developing a compassionate image and about developing feelings of compassion toward yourself. Imaginal exposure exercise is conducted and viewed through the lens of previous self-compassionate image. The latter part of the session is dedicated to values exploration with the use of the ‘Attending your 80th birthday party’ exercise. Definitions of life directions and life destinations are discussed. Life domains and goals are explored. |
| Session 4 Week 7 |
Developing a different relationship to thoughts and Goal Stepping. |
The session begins a mindful ‘seeing’ exercise to explore the breath, sounds, and perceptions. An overarching theme for the session is centred around Rumi poem ‘The Guest House’. The use of improv-based exercises is used to elicit fusion, to challenge the urge to ‘do things right’. This part of these session is helpful to teach participants about staying in the present moment and connecting with our common humanity. The exercise illustrates the process of letting go of the urge to be perfect and replacing self-judgment with self-compassion. |
| Session 5 Week 9 |
Self-Compassion, Being with Anxiety and Introduction to VITAL. |
In this session, participants build on acceptance of bodily sensations beginning with a group stretching exercise. The theme of this session extends on the acceptance process with the ‘taking a compassionate break’ exercise. Two or more physiological exposure exercises of ‘being with the anxiety’ are conducted with the entire group such as running on the spot, head lifting, breathing through a straw and hyperventilating. |
| Session 6 Week 11 |
VITAL Action Exercises, VITAL Action Worksheets and Four-Part Plan for Taking VITAL Action. |
The session begins with imagining taking VITAL action by asking participants to focus on a social situation of valued importance where they would like to take action in as much detail as possible noting any urges or safety behaviours that arise and when it does, defusing from this. The general theme of the excise is to extend on the imagery exercise and consider Vital Action Exercises or willingness exercises. |
| Session 7 Week 13 |
Taking VITAL Action - Continued. |
The beginning of the session further builds on the acceptance process of self-compassion with the well-known loving-kindness mindfulness exercise. Conduct VITAL-Action exercises based on participants' goals. Participants are to share at least one step/activity/goal that they will carry out between now and the next session. |
| Session 8 Week 15 |
Consolidations and troubleshooting VITAL Actions Exercises. |
This session advances the foundations and skills learned in the previous session allowing participants to troubleshoot any barriers or obstacles that inhibit progress. Group processes and dynamics become especially helpful here for group members to learn and share with one another. Previous exercises are rehearsed in this session for participants to practice and build upon. The session begins with imagining taking vital action exercises similar to previous sessions. |
| Session 9 Week 17 |
VITAL Action Exercises. |
This session takes a similar format to session 8. Specific exercises are chosen by individual group members to explore. Group members identify at least one action they will carry out between sessions and anything they would like to do in the final session. |
| Session 10 Week 19 |
Consolidations and troubleshooting VITAL Actions Exercises. |
This session serves as a summary of the application of VITAL Action and the ACT model for SAS. A review of each participant’s progress since the start of the group is discussed and accomplishments are shared and what they would like to continue to work on going forward. |
My name is Liam Reilly. I hold general registration as a psychologist, and I am approved to practice by AHPRA through the Psychology Board of Australia.
I am competent working with a range presentation of clients from ages 8 up. I have a diverse skill set learnt through a variety of work setting in community mental health, rural health services, Drug and Alcohol Rehabilitation, and as a FIFO psychologist to rural and remote locations across Western Australia.
I seek to be a warm, non-judgemental, and compassionate clinician to better understand a person’s own unique experience, context, and how it impacts on behaviour. My treatment approach is guided by the philosophy that every person strives for and has the capacity to fulfil their own potential for a rich, full, and meaningful life that promotes positive mental wellbeing and relationships. Being trained in trauma informed care, I can provide a supportive and safe environment for people to heal and grow beyond trauma.
