Social Anxiety Disorder: Occupational Therapists and Mental Health

Let’s talk about how occupational therapists and mental health interventions address social anxiety disorder.

In the USA, anxiety disorders are the most common mental health conditions, and social anxiety disorder is just one of them. Approximately 15 million American adults suffer from social anxiety disorder (previously called social phobia). This disorder has equal incidence across males and females, and onset is around age 13. Furthermore, a variety of treatments are used to assist individuals. Let’s discuss how occupational therapists and mental health interventions can help persons who struggle with social anxiety to lead better lives. 

What is Social Anxiety Disorder?

Social anxiety disorder is a mental health issue. It involves intense and persistent anxiety over or fear of being observed and wrongly judged by other people. This fear is often quite debilitating, as it disrupts school, work, and your daily life. Social anxiety disorder far exceeds being shy, as it can hamper your ability to attain your full potential.

Symptoms of Social Anxiety Disorder

These symptoms arise when a person has to perform before others or has to socialize with unfamiliar individuals. They include:

  • Excessive blushing, sweating and trembling
  • Heart palpitations and a feeling of “mind blankness”
  • Nausea or a sick feeling in the stomach
  • Exhibiting a stiff body posture
  • Avoiding eye contact and speaking in low tones
  • Difficulty being around and interacting with unfamiliar people
  • Feeling embarrassed and awkward in front of others
  • Excessive fear of being perceived in the wrong light
  • Avoiding places where there are other people

What Causes Social Anxiety?

What causes social anxiety? Let’s discuss a few factors identified by research


If you or a loved one suffers from social anxiety, then knowing its possible origins is helpful. 

It is believed that this condition may have a genetic cause. However, no one knows why some family members may have it while other members don’t.

Excessive isolation (such as solo studying in academic settings) can lead to social anxiety. Also, having parents or guardians who were overprotective, controlling, restrictive, or anxious may be another factor. Traumatic and persistent bullying, emotional, verbal, physical, and sexual abuse can cause a person to experience social anxiety. 

Scientists have discovered that several areas of the brain are involved in fear and anxiety impulses. The amygdala serves as the center of fear and anxiety generation, and it is a part of the emotional brain. When the frontal lobe that houses our sensations and thoughts (or the cognitive brain) fails to control the impulses from the amygdala, then overwhelming anxiety occurs. 

If someone’s socialization skills are underdeveloped, then this could mean unproductive social interactions, fear about future interactions, and then social anxiety. Researchers are currently exploring how stress and environmental factors can impact social anxiety symptoms.

How Can an Occupational Therapist Help You

An occupational therapist works with clients of all ages to help them manage their anxieties and fears and lessen the impact on their daily lives. Your therapist will work with you to see how the condition affects your thoughts, feelings, and actions. 

They will also help you outline your future treatment and life goals and design a treatment plan to help you achieve them. This treatment plan will be uniquely designed for your needs and features goals that utilize the SMART principle (specific, measurable, achievable, realistic, and timely). Your occupational therapist will work alongside other members of your medical team to ensure that you get holistic healthcare to manage your social anxiety symptoms. 

Types of Social Anxiety Treatments

Several mental health interventions can be used to manage social anxiety:


Cognitive-behavioral therapy (CBT) is a special category of psychotherapy that is useful in treating social anxiety disorder. CBT helps you identify negative thought patterns, replace them with realistic and positive ones, and also manage how you behave and react to situations that would lead to anxiety and fear. 

A CBT therapist can also help you learn and practice appropriate social skills to facilitate improved communication and interaction with others. These sessions can also be formatted to contain some group therapy to facilitate better mastery of communication skills. 

Support Groups

Many people who suffer from social anxiety may also find support groups quite helpful. When you’re in a group of those who share your concerns, then you can get unbiased, honest, and thoughtful feedback about how you are perceived.

This will help you to learn that your constant worry about what others are thinking about you may not be correct. Your concerns about being judged and rejected may be distorted. You can also benefit by learning how other people with social anxiety disorder approach and master their fear of social situations.  

Relaxation Techniques

Relaxation techniques help manage social anxiety disorder


Learning and applying these techniques can help you overcome the physical symptoms of social anxiety:

Biofeedback Self-Awareness

This approach uses sensors to collect data about your physiological response to anxiety.  Your breathing, heart rate, and muscle tension fluctuations will be measured. Your therapist will help you understand how your body reacts to increasing anxiety levels and how you can control these responses. 

Pacing Strategies

Constant exposure to anxiety can be quite exhausting. Your therapist will also teach you how to pace your activities throughout the day. 

Grading Activities

Your therapist will help you overcome specific events that would often peak your anxiety levels via a series of small, deliberate steps. 


Exercise can be a great stress reliever even while you maintain your best health. Studies show that as little as 30 minutes of exercise, three to five times per week offers a lot of relief.


Your physician has access to three main categories of medications to help manage your social anxiety:


These anti-anxiety medications are very strong and provide immediate relief by minimizing anxiety. But they are not usually taken on a long-term basis as it’s easy to build up a tolerance and then requiring higher doses to have the same impact. 

To avoid drug dependency or drug abuse, doctors only prescribe anti-anxiety medications for a shorter time frame. This practice is also quite useful for older adults.


Antidepressants are primarily used to manage depression, but they can also be used to treat social anxiety disorder. Although, you have to take these antidepressants for several weeks before they start to work.  

Furthermore, these antidepressants could also result in side effects such as headaches, nausea, and insomnia. These side effects are not too severe for many people, particularly if the dose begins low and is gradually increased over time. We advise you to speak with your doctor about any side effects that you may have. 


Beta-blockers are medications that can block some of the physiological effects of anxiety such as elevated heart rate, sweating, or tremors. These beta-blockers are usually the preferred choice for the “performance anxiety” aspect of your condition. 

Your physician will work with you to discover the best type and dose of medication and the duration of treatment that is suitable for you. Many individuals report an improvement in their symptoms when they combine medication, CBT, and other psychotherapies. 

If your physician recommends that you get medication, then don’t give up on your treatment too early. Remember, it may take a while before you begin to see results. Ensure that you get sufficient sleep, exercise, eat a balanced diet and rely on trusted family and friends for support.

What is the Best Therapy for Social Anxiety Disorder?

CBT was found to be the best therapy for social anxiety disorder


CBT is the most common and effective psychotherapy to manage the symptoms of social anxiety disorder. It is also effective when you conduct it individually and in groups. For exposure-based CBT, you would need to do work gradually as you overcome more fearful situations.

How CBT Works to Treat Social Anxiety

CBT uses cognitive restructuring to treat social anxiety. You and your therapist will work to identify and contend with all negative beliefs that you may hold about yourself and others. This serves as a great opportunity to examine your inner self and seek to replace these adverse thoughts with better, positive thoughts. 

The two types of exposure that could aid those with social anxiety are:

  • In vivo exposure: This type of therapy places you in situations that you would generally avoid. 
  • Interoceptive exposure: You are exposed to sensations that you don’t like that tend to arise as a result of heightened anxiety. 

Both types of exposure aim to reduce your feelings of anxiety. This occurs when you are exposed to the thing that you dislike without you having a negative response. This method helps you to overcome social anxiety in specific situations. 

Overcoming Challenges to Accessing Healthcare 

Social anxiety treatments may not always be widely available. Contacting a therapist could be difficult for you if you suffer from severe social anxiety. However, this fear doesn’t need to hinder you from getting the help that you need. Here are few ways that you can overcome your anxiety by reaching out to others:

  • Ask a supportive family member or friend to make the first contact with the therapist. You can even ask them to set up the first appointment. 
  • Write an email to the therapist of your choice. This may be far easier than speaking over the phone.
  • Choose a therapist who offers online sessions or one over the phone.

We understand that you may fear reaching out for help. But always try to get the help you need for your best health and wellbeing.

Complementary Therapies for CBT

Although CBT may be the best psychotherapy option to manage your social anxiety, there are options available. Let’s quickly consider a few of them:

Social Skills Training 

This will help to develop strong communication skills and improve assertiveness. This is often done via role-playing scenarios with your therapist. 

Psychodynamic Therapy (PDT)

PDT is currently undergoing studies to assess if it is a good option for managing social anxiety. This form of therapy involves self-reflection, and far more sessions than with CBT. 

This therapeutic relationship is also useful in social anxiety treatments. It can also reinforce your positive beliefs about interacting with other persons and encourage you to communicate with others. 

Helpful Self-Care Tips

There are several self-care approaches that you can use to alleviate your social anxiety. You can:

  • Research more information about social anxiety 
  • Join a social anxiety support group
  • Exercise regularly for mental and physical wellbeing
  • Reduce your alcohol and caffeine intake
  • Get enough sleep each night
  • Have the right focus outward and not inward in your social situations
  • Volunteer for a charity of your choice

Get the Support That You Need

Occupational therapists and mental health interventions are critical in treating social anxiety. Do you need an occupational therapist in Shelton, CT? Then visit Moving With Hope. We have highly-trained occupational therapists and other medical professionals to provide you with the best healthcare. Contact us today to discuss how we can help you manage your social anxiety symptoms and look forward to a better future.

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