What is CBT, and how can it help you take control of your social anxiety?

Social anxiety is an intense fear of being watched or judged by others, and is far more common than you may realize, being the 3rd most diagnosed mental health condition. If you experience social anxiety, you may find that it holds you back in your career, relationships or even daily activities such as going to the supermarket. 

However, there is treatment available. Cognitive Behavioral therapy (otherwise known as CBT), is the most effective treatment for social anxiety. Engaging in therapy is a challenging, personal journey that requires commitment in order to see positive change.

The reason CBT works so well with social anxiety is because it helps the individual understand their thought patterns, behavior and triggers, giving them the tools to understand how to shift these to control the anxiety. The Alena app provides this therapy course, available 24/7, in the comfort of your own home. 

What is CBT, and how does it work?

Back in the 1960’s, CBT was developed by a US psychiatrist, Aaron ‘Tim’ Beck, originally focusing on treating depression. He developed the therapy as a way of helping people understand how they interpret what happens to them and identify their beliefs about themselves. 

He found that people often experience ‘cognitive distortions’, or rather, errors in their memories or perceptions of events, which then exacerbates their depression. Beck created CBT to concentrate on helping them reshape these interpretations, giving them the tools and understanding to refocus their thought patterns, and reduce their depression. 

Beck brought on other psychiatrists to help him develop the CBT methodology further, including David Clark, who previously focused much of his work on panic disorder. He took the CBT model and applied it to anxiety disorders, which are born from different thought patterns to those of people experiencing depression. This Clark and Wells model of CBT focused on understanding the main fears triggering the anxiety, and providing patients with the skills of refocusing their attention around these main fears. 

How CBT can help those with social anxiety

With social anxiety, the central fear is around being watched or being negatively judged by others. If you experience social anxiety, you may develop symptoms such as excessive sweating, avoiding eye contact, shaking, struggling to speak, or feeling flushed whilst in public. 

As a way of managing these symptoms, often you develop safety behaviors to help manage the anxiety. These could vary from totally avoiding social situations, sitting on your hands to prevent people seeing that they’re shaking, or standing in the corner of the room so people don’t speak to you. 

Understanding these symptoms and behaviors means that you can start to shift away from them and manage your anxiety. The therapy enables you to develop your own map of behavior, identifying your triggers and responses, and building the skills and confidence to start changing them. 

There are other models of CBT for social anxiety, however Alena uses the Clark and Wells model, which has a huge amount of evidence and research behind it, showing that it is the most effective model of treatment for social anxiety disorder. It is also recommended by the NICE guidelines in the UK. 

How does the Alena CBT model work?

Our team of therapists and neuroscientists have taken the Clark and Wells model, and broken it down into the four cognitive processes of social anxiety. A ‘cognitive process’ is a mental pattern that contributes to and perpetuates your social anxiety. The four cognitive functions highlighted in our CBT course are: Beliefs, Attention, Avoidance and Rumination. 

The Alena app has a module per cognitive process. Each module begins with a neuroscience-based assessment which analyzes your cognitions (or brain patterns) to provide you with a personalized score against each cognitive process. These scores will then highlight to you which areas you should concentrate on within your CBT course. 

We would recommend you still complete all four modules, but the scores enable you to understand your own behavior and patterns specifically, and evaluate where to concentrate your practice. You can continue to complete the assessments to see how you improve throughout your therapy. 

In order for you to start noticing benefits from the Alena app, we would recommend doing the therapy as part of your daily routine, for 15 minutes per day. After one month, you should start to notice the benefits from it, but we would recommend continuing the practice to keep improving and prevent regression. 

Understanding the cognitive processes of social anxiety

The four cognitive processes of social anxiety are beliefs, attention, avoidance and rumination. 

Beliefs - these are the ideas that you have about yourself, the social situation, and our interpretation of how others are judging us. This CBT module helps you understand your unique anxiety response and how it affects your thinking patterns. 

For example, thinking “I come across as stupid, and I have nothing to contribute to this conversation” whilst in a work meeting. 

Attention -  this is understanding the relationship between your attention and your anxiety, and how to use it to your advantage. This module helps you identify where you are focusing your attention, and how to shift it.

For example, if you are in a job interview, and you are paying more attention to how much your voice is shaking than listening to the questions and thinking of how to answer them. 

Avoidance - this means identifying your safety behaviors and carrying out personalized, realistic and gradual experiments in order to shift your behavior in real life. This module helps you acknowledge these behaviors and how to rely on them less. 

For example, going to the self-checkout at the supermarket instead of going to a cashier.

Rumination - this is understanding your negative thought spirals, how they start and what to practice in order to break free from them. This module helps you recognise a negative thought spiral and how to evaluate the evidence, rather than assumptions in order to prevent rumination. 

For example, fixating on a memory of how someone responded to something you said at an event, and constantly over-evaluating that memory trying to find meaning in their response. 

What are the benefits of engaging in the Alena CBT app?

Using an app like Alena for cognitive behavioral therapy has a number of benefits. 

  1. Access to therapy whenever you need it. There are no waiting lists, so you can get quick access to the appropriate evidence-based therapy for you. The app is available 24/7, so you can use it whenever you need, in the comfort of your own home.

  2. A personalized journey for you. With the neuroscience-based assessments providing your scores throughout your journey, you can focus on what’s the priority for you. 

  3. Totally anonymous, with no fear of judgment - Seeing a therapist for someone with social anxiety could be intimidating, and it may be hard to be completely honest with your answers if you are concerned about how they may be interpreted. With the Alena app, you’re safe in the knowledge that no-one except yourself will ever see your answers, it’s entirely anonymous with incredibly secure data privacy. 

  4. Take control of your own mental health, and become your own therapist. Using the Alena app gives you the tools to understand your own behavior and thought patterns, giving you the skills to manage these on your own. This means you are able to be in control of your mental health, and able to continue improving and engaging in the exercises for the long-term. 

How do I start with Alena therapy?

If you’re interested in learning more about the Alena app, or testing out the therapy yourself, you can join the waiting list to hear more about when the app launches. 



References

Meta-analysis of technology-assisted interventions for social anxiety disorder: https://pubmed.ncbi.nlm.nih.gov/27376634/

Social Anxiety Disorder: Recognition, Assessment and Treatment. (National Library of Medicine): https://www.ncbi.nlm.nih.gov/books/NBK327674/

Cognitive behavioral therapy in the treatment of social phobia (National Library of Medicine): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016703/

Internet-Delivered Cognitive Therapy for Social Anxiety Disorder: A Development Pilot Series (National Library of Medicine): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3695729/

Social anxiety disorder: recognition, assessment and treatment (NICE Guidelines); https://www.nice.org.uk/guidance/cg159

What is social anxiety – and what it isn’t - The Alena blog

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