By Nelson Binggeli, PhD
The psychotherapeutic approach for social anxiety with the most evidence for effectiveness is called Cognitive Behavioral Therapy (CBT). CBT includes a cognitive component and a behavioral component. Cognitive refers to the thoughts we have that influence the way we feel and behave. The behavioral component focuses on how the behaviors we engage in tend to reinforce future behaviors and beliefs we have about ourselves.
In the cognitive component of CBT, people learn how to identify their thoughts, evaluate their validity using evidence and reason, and if warranted, to develop thoughts that are more realistic and useful. This component is known as cognitive reappraisal. Social anxiety is driven by a heightened concern about being evaluated negatively by others. These thoughts often involve overestimations of the possibility of negative evaluations, and an overestimation of the severity of the consequences of negative evaluations. Cognitive therapy helps people with social anxiety to recognize these overestimations, and to develop more accurate and helpful thoughts.
Social anxiety is maintained by certain behaviors, particularly the avoidance of social situations that cause anxiety. Avoidance gives a person immediate relief, but in the long term impairs their quality of life. Avoidance also prevents a person from learning how to deal with social situations and reinforces their beliefs that social situations are to be feared. The behavioral component of CBT involves voluntarily exposing oneself to the social situations one fears, starting with the least feared and working gradually up to the most feared. This component is known as exposure therapy. In CBT, the therapist helps prepare the client to engage in these "exposures" by helping them develop more helpful thoughts (the cognitive component) and by helping the client practice (or role play) these situations within the therapy session.
The length of CBT typically ranges from 12 to 24 sessions, and may occur in individual or group therapy. In numerous research studies, this approach has been found to significantly reduce social anxiety in over 75% of those who participate in it. National Public Radio did a very good story on CBT for social anxiety, and it is available online as a podcast.
Addendum
I wrote the article above several years ago. More recent research and my own clinical experience suggests that adding components of Acceptance and Commitment Therapy (ACT) to the well-established CBT principles increases the effectiveness of the therapy.