ACT for Social Anxiety: Obstacles and Challenges

Brian-Pilecki

Warren Alpert Medical School, Brown University Portland Psychotherapy

Key Points

  1. Change is difficult and may well not be linear. This should be normalized.
  2. Values can be used to orient behavior and focus on what can be added, like compassion, instead of what can be taken away, like anxiety.
  3. Family and friends may enable old behaviors, so it is important to involve them in the process.
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A Winding Path of Change

There are some common treatment obstacles that might arise with clients with social anxiety. The first is that avoidance behaviors are typically quite entrenched. As Charles described it, he had spent years increasingly avoiding social situations. Change is hard: making changes in that pattern of behavior is going to take some time, and it won’t be a linear, onward path. It’s going to be a few steps forward, one step backward, and so on.

A solution is simply to normalize that pace and style of change. It’s understandable that people might slip into old habits and routines. Let’s say that Charles gets a bit better at practicing self-compassion, but then one day starts really beating himself up again. He might also beat himself up for beating himself up, which is a funny thing that humans tend to do. By normalizing it, affirming this is all just part of change, we can help Charles not to get too stuck on what he perceives as failure, and learn instead to see it as a step in an ordinary process.

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