There are three main approaches therapists currently use in treatment: Dynamic, Behavioral, and Cognitive.
The Dynamic approach explores underlying issues, childhood experiences, and attempts to make the unconscious conscious. Perhaps someone picked on you or teased you as a small child. As a result you may feel that world is not a safe place although you cannot put your finger on why it isn’t safe.
The Behavioral approach looks at how we learn and develop behaviors over time. Such as, if someone teases us or bullies us, we learn to associate people with shame and then we do everything that we can to avoid being teased, bullied, or shamed. We allow ourselves to develop a fear of other people and expect that because one person teased us, everyone will tease us.
The Cognitive approach focuses on what we think about our situation, sometimes before we even realize that we have had a thought. So when I think I have to go to work or I would like to go to the mall, the first thing I think is, “ugh, the people” and I immediately have a sense of fear or foreboding. Even if it is an activity that I want to do (gym, yoga, shopping, movies, etc) I will not allow myself to go because I think other people are not safe.
Treatment for Social Anxiety is often behavioral in nature, with the therapist guiding the client through exercises more closely resembling the feared object or situation. I start someplace (online or in the person’s home) that the person feels safe. Then, through behavioral, and sometimes cognitive exercises, we help people face their fears and behaviorally learn new associations in a safe and fun way. Exploring underlying issues can also be beneficial, if the client wants to understand the root of their problem, but it is not necessary for successful treatment.
Prognosis for Social Anxiety is very good if treated effectively.