The Shyness & Social Anxiety Workbook
230of the room). Speak crisply and pronounce your words clearly. Avoid saying
“uh” and “um.” Finally, avoid speaking too quickly. Going too fast is one of
the most common mistakes people make during presentations, particularly
when they are feeling anxious.
UÊMake eye contact with the audience members during the talk.
UÊTry to move around when you are speaking. Walk around the front of the
room rather than staying planted at a podium. Don’t put your hands in
your pockets. Instead, gesture with your hands to emphasize key points.
However, keep your hands away from your face and hair.
UÊPresentations are often less interesting when they are read verbatim. If you
read a presentation word for word, you also run the risk of panicking if you
lose your place. Instead, we recommend speaking from a detailed outline
with lots of headings, bullets, and so on. An outline will make sure that all
the information you need is available and easy to access, even if you lose
your place. It will also force you to be somewhat spontaneous during the
presentation. If the thought of not reading your speech is too scary, another
option is to bring both an outline version and a fully written version. If
necessary, you can switch to reading your presentation if using the outline
alone doesn’t work.
UÊDon’t talk down to your audience. They probably know more than you
think they do. Even if the material is new to them, they will not appreciate
being talked to like children—unless, of course, they are children! Make
sure your tone of voice and the things you say are not condescending.
UÊRepeat the main points of the presentation frequently. Audience members


UÊRepeat the main points of the presentation frequently. Audience members
will not hear everything you say, and if they miss an important point you
may lose them for the rest of the presentation unless the important points
are repeated.
UÊKeep it simple. Don’t try to discuss more than your time allows.
UÊMake sure you are prepared to handle questions. Consider bringing addi -
tional information (a reference book, notes, and so on) that may be needed
to answer certain types of questions. No matter how silly a question is, try
to answer it tactfully and show respect for the person who asked the ques -
tion (for example, “That’s an interesting question . . .”). Finally, repeat all
audience questions before you answer them. Chances are good that people
in the back of the room will not be able to hear some of the questions the
ﬁrst time they are asked.


Communicating More Effectively
231UÊBe yourself during the talk. Audiences prefer a speaker who is down to earth
and genuine rather than someone who looks as if he or she is trying too hard
to be entertaining or to impress the audience.
After the Presentation
Following your presentation, it is helpful to evaluate the quality of your performance,
basing your evaluation on whether you followed the suggestions provided in this chapter.
Don’t base your self-evaluation on whether you were anxious during the presentation or
whether your anxiety symptoms showed. The presenter’s anxiety or lack thereof is only
one small aspect of what makes an effective presentation.
Social anxiety is associated with the tendency to be an overly harsh critic of one’s
own performance. Therefore, we suggest that you obtain objective feedback from your
audience members as well. This can be done informally by asking people what they
thought of the talk. Or, if appropriate, it can be done more formally by handing out an
anonymous evaluation form that requires audience members to rate their impressions of
certain aspects of the presentation, such as the format of the presentation, the content
(for example, interest level, relevance, difﬁculty, and so on), the speaker (for example,
presentation skills, organization, expertise, clarity), use of audiovisual resources, and the
location (for instance, lighting, temperature, seating comfort). In addition, make sure to
include space on the form for audience members to write their impressions (strengths of
the presentation, areas for improvement) in their own words.


CHAPTER 11
Maintaining Your
Improvements and
Planning for the Future
The purpose of this ﬁnal chapter is to discuss strategies for ensuring that the gains you
have made so far are maintained over the coming months and years. Perhaps the most
important suggestion we can offer is that you should continue to use the strategies
described in the ﬁrst ten chapters. Continuing to use approaches that were helpful in
getting you to where you are now will ensure that you maintain your gains and that your
anxiety continues to decrease over time.
THE END OF TREATMENT
In some ways, treatment is never ﬁnished. Although most people experience improvements
using the strategies described in this book, it’s common for people to continue to suffer
from anxiety in some social situations from time to time. Like back pain, depression, and
high blood pressure, anxiety is often a chronic problem that comes and goes, but it can
also be controlled. It will be helpful for you to continue to use the methods described in
this book to make sure that your anxiety doesn’t worsen. In fact, an important goal of
cognitive behavioral therapy is to teach people to be their own therapists. If this book
has been effective, chances are that your anxiety is much better than it was and you have
learned some strategies that you can continue to use as you move forward.


The Shyness & Social Anxiety Workbook
234If treatment has been less effective than you would have liked, this is a time to ﬁgure
out why. Here are some possible reasons to consider:
UÊInadequate dosage . Typically, we think of dosage in the context of medica -
tion treatments, and certainly an inadequate dosage of medication (taking
too little medication or taking medication for too short a time) can lead to
a lack of improvement. However, the term “dosage” can also be applied
to cognitive behavioral strategies. There is evidence that improvement is
directly related to the amount of homework a person completes. So, if your
exposure practices are too short or too infrequent or you don’t practice
challenging your anxiety-provoking thoughts, your anxiety may not have
improved as much as you had hoped.
UÊStress . If you were under a lot of stress while working on the strategies in
this book, you may have found only limited beneﬁt. For example, if you
were working very long hours, dealing with family stresses, or coping with
serious health problems, you may not have been able to devote as much
time to this treatment as you might have liked. Our recommendation is to
try again once the stress in your life has subsided. Stress can also lead to a
return of fear, an issue to which we will return shortly.
UÊOther psychological problems . In some cases, shyness and social anxiety
are part of another problem. For example, someone with an eating disor -
der may have high levels of social anxiety for fear of looking fat in front
of others. Although the strategies in this book may help in such a case, it
would also be important to directly address the eating issues.


would also be important to directly address the eating issues.
UÊOther life issues . For some people, years of social anxiety can lead to
various long-term problems, including chronic unemployment, extreme
loneliness, severe depression, or substance-use problems. Without address -
ing these larger issues, the strategies described in this book may not have
much impact on improving your overall quality of life. It will be important
to ﬁnd some help and support for these larger issues as well. Chapter 4
includes some recommendations for ﬁnding a therapist. Professional help
may be able to steer you in a direction toward solving these other problems
in addition to your anxiety.
WHY FEAR RETURNS AND WHAT YOU
CAN DO ABOUT IT
Most people who receive treatment for social anxiety experience long-lasting improve -
ments in their anxiety, particularly following cognitive and behavioral treatment.


Maintaining Your Improvements and Planning for the Future
235Nevertheless, there are a number of different reasons why fear may return for some
individuals. If your fear returns, the best thing to do is to resume using the strategies
that were most helpful to you the ﬁrst time you overcame your fear. Social anxiety that
comes back sometime after a period of improvement may even be easier to overcome
the second time around.
Discontinuing the Treatment Strategies Too Early
or Too Quickly
Discontinuing your cognitive therapy and exposure practices may increase the like -
lihood of experiencing a return of fear, particularly if you stop using these techniques
before you have completely overcome your anxiety. We recommend that you continue
to challenge your anxiety-provoking thoughts from time to time for as long as you con -
tinue to feel anxious. When your fear has decreased signiﬁcantly, you can stop using
the cognitive diaries. However, you should continue to use the cognitive techniques
informally, by silently asking yourself appropriate questions (for example, “Is there some
other, nonanxious way of interpreting this situation?”).
In addition, you should take advantage of opportunities to expose yourself to previ -
ously feared situations even after your fear has been reduced. Sometimes life circum -
stances (such as being busy at work or school, or recovering from the ﬂu) make it hard
to practice exposure on a regular basis. Whenever possible, continue to confront your
feared situations from time to time. Occasional exposures should help to prevent your
fear from returning.
Stopping medication too early may also increase the risk of your anxiety returning.
As discussed in chapter 5, relapse following discontinuation from treatment with antide -


As discussed in chapter 5, relapse following discontinuation from treatment with antide -
pressants is believed to be less likely when treatment has continued for at least a year. So,
it’s best not to stop medication treatment the moment you start to feel better.
Coming off medication suddenly may also increase the risk of your fear returning.
Discontinuation from some antidepressants and from almost all anti-anxiety medications
is associated with symptoms of withdrawal, which often mimic the symptoms of anxiety.
These withdrawal symptoms may prompt some people to resume their old habits of
avoidance and fearful thinking. The best way of preventing withdrawal symptoms fol -
lowing discontinuation from medication is to reduce the dosage very slowly over time.
We strongly recommend that you not reduce or stop your medication without ﬁrst
 consulting with your doctor.
Life Stresses
Sometimes, an increase in the stress in your life can lead to a return of anxiety
and fear. For example, if you experience a stressful life event (increased hours at work,


The Shyness & Social Anxiety Workbook
236relationship problems, ﬁnancial difﬁculties, health problems, family tensions, death of a
close friend, and the like), you may ﬁnd that your anxiety in social situations gets worse.
Sometimes, this worsening of anxiety occurs while the stress is ongoing; other times it
may occur shortly after the stress has ended.
The relationship between stress and increased social anxiety is not surprising. Most
people respond to stress in characteristic ways. Some tend to respond physically by
experiencing more colds, headaches, increased blood pressure, and other physical ail -
ments. Others may fall into bad habits, such as smoking more, increasing alcohol or caf -
feine consumption, eating unhealthy foods, or exercising less. Still others may respond
emotionally by becoming more anxious, depressed, or irritable. If your natural pattern
has been to experience anxiety in social situations, stress may cause some of your old
responses to resurface.
Stress tends to increase a person’s arousal level, so breathing becomes heavier, heart
rate increases, and other symptoms of arousal become more intense. When you’re under
stress, it doesn’t take much change in your anxiety level for the feeling to become more
noticeable than usual. Situations that are normally okay may seem overwhelming when
you are experiencing other stresses in your life.
Most of the time, the increase in social anxiety following stress is temporary; when
the stress level improves, the anxiety decreases again. However, if you respond to your
increased anxiety by falling back into your old habits of anxious thinking and avoidance
behaviors, you may ﬁnd that the increased social anxiety continues even after the stress
has passed. If your anxiety returns following a stressful life event, the best thing to do is


to reread the relevant sections of this book and resume using some of the strategies that
you found helpful the ﬁrst time around.
Encountering a New and Unexpectedly Difﬁcult Situation
Although you may think you have overcome a particular fear, it is possible that some
fear remains but that you just haven’t had a chance to encounter a sufﬁciently challeng -
ing situation until now. One of our clients was recently surprised to experience intense
fear while unexpectedly having to give a toast at his father’s birthday party. He had
worked very hard to overcome his fear of public speaking at work. After a few months
of practice, he found he could speak comfortably in meetings, and he even gave long
presentations to groups of 200 or more with almost no fear. One day, he was asked on
the spur of the moment to make a toast at his father’s birthday party to about thirty
friends and relatives whom he had known his whole life. This made him very nervous.
Although he had successfully overcome his fear of speaking in formal work situations,
he had never had the opportunity to speak in an informal and personal situation like a
family party. For him, giving a toast in front of friends and relatives was actually a new
situation that he hadn’t had the chance to practice previously.


Maintaining Your Improvements and Planning for the Future
237Experiencing a Trauma in the Feared Situation
Sometimes, experiencing a trauma in a social situation can lead to a return of fear.
For example, if your audience during a presentation is particularly cold and unfriendly,
if you are rejected by someone whom you care about, or if your boss is extremely criti -
cal of your performance in a meeting, you may ﬁnd that you’re more anxious the next
time you return to the situation. The fact that you had a particular anxiety in the past
makes it more likely that it will return if you experience a negative event in a situation
that mirrors this old fear.
If you experience a negative event in a situation that you previously feared, the best
thing to do is to return to the situation as soon as possible. If you begin to avoid the
situation, your anxiety will be more likely to return. In addition to exposure, try chal -
lenging your anxious beliefs by considering alternative, nonanxious interpretations of the
negative event you experienced.
PREVENTING YOUR FEAR FROM RETURNING
Although your anxiety is unlikely to return after you have learned to be more comfort -
able in social and performance situations, there are no guarantees. Nevertheless, there
are a number of things that you can do to improve your chances of maintaining your
gains.
Continue to Use the Cognitive Therapy and Exposure
Strategies
As we’ve discussed, continuing to challenge your anxious thoughts informally and
to practice exposure from time to time will help you to maintain the improvements that
you have made so far. We also recommend that you reread relevant sections from this
book occasionally to reinforce what you have learned and to make sure that you haven’t
forgotten any important principles.


forgotten any important principles.
Practice Exposure in a Range of Situations and Contexts
Your gains are likely to last longer if you practice exposure in a wide variety of situ -
ations and contexts. For example, if you’re fearful of starting conversations, rather than
practicing starting conversations only at work, we recommend that you practice making
conversation in other situations as well (for example, at home, at parties, at the bus stop,
in the elevator, and so on).


The Shyness & Social Anxiety Workbook
238Take Advantage of Opportunities to Overlearn
Overlearning  involves (1) practicing exposure so many times that it becomes boring
and second nature, and (2) practicing exposure in situations more difﬁcult than those
you encounter in your everyday life. For example, if you are fearful of having your hands
shake while having a drink, you can practice having them shake so much that you actu -
ally spill some of your drink. (Make sure your glass is ﬁlled with water and not grape
juice!) Repeat this practice until it no longer causes anxiety. Or, if you’re fearful of
making a minor mistake when talking to a stranger, you can practice purposely making
obvious mistakes while speaking to people you don’t know.
Overlearning is thought to offer protection from experiencing a return of fear. There
are several advantages of practicing exposure to more difﬁcult situations than those you
normally encounter. First, practicing in more challenging situations will automatically
make the less challenging situations seem easier. Second, practices in difﬁcult situa -
tions will further challenge your anxious beliefs. For example, if you learn that nothing
bad happens even if you purposely make a big mistake during a presentation, you may
become less fearful of accidentally making a small mistake when speaking in public.
Finally, overlearning provides room for some of your fear to return without causing
signiﬁcant impairment in your life.
WHERE TO GO FOR MORE INFORMATION
For those who want additional information on social anxiety and related topics, we have
included more useful information at the back of this book. Our list of recommended
readings includes books on social anxiety, other anxiety problems, cognitive behavioral
therapy, and related topics. This list also includes information on two videos on the


therapy, and related topics. This list also includes information on two videos on the
treatment of social anxiety. Readings are included both for consumers and profession -
als. We have also included a resource list of national and international organizations that
provide information (including referrals to experienced therapists) to people who suffer
from social anxiety and for professionals who have an interest in this topic. Finally, we
have included a list of websites that provide information on social anxiety and effective
treatments.
We hope that you have found the strategies described in this book helpful. Chances
are that you will need to continue to use these tools for some time before experiencing
a reduction in social anxiety that has a noticeable impact on your day-to-day life. We
recommend that you reread the sections that were particularly useful or inspiring to you.
Most of all, we wish you good luck as you learn to deal with stressful social situations
with a new, well-earned sense of conﬁdence.


Recommended Readings
SHYNESS AND SOCIAL ANXIETY:
SELF-HELP BOOKS
Antony, M.M. 2004. 10 Simple Solutions to Shyness: How to Overcome Shyness, Social Anxiety, and
Fear of Public Speaking . Oakland, CA: New Harbinger.
Hope, D.A., R.G. Heimberg, H.R. Juster, and C.L. Turk. 2000. Managing Social  Anxiety .
New York: Oxford.
Rapee, R.M. 1998. Overcoming Shyness and Social Phobia: A Step-by-Step  Guide . Lanham, MD:
Jason Aronson.
Stein, M.B., and J.R. Walker. 2002. Triumph Over Shyness: Conquering Shyness and Social Anxiety .
New York: McGraw-Hill.
SOCIAL AND COMMUNICATION SKILLS:
SELF-HELP BOOKS
Dating and Meeting New People
Berry, D.M. 2005. Romancing the Web: A Therapist’s Guide to the Finer Points of Online Dating .
Manitowoc, WI: Blue Water Publications.
Burns, D.D. 1985. Intimate Connections . New York: Signet (Penguin Books).


The Shyness & Social Anxiety Workbook
240Jacobson, B., and S.J. Gordon. 2004. The Shy Single: A Bold Guide to Dating for the Less-than-Bold
Dater . Emmaus, PA: Rodale.
Katz, E.M. 2003. I Can’t Believe I’m Buying this Book: A Commonsense Guide to Successful Internet
Dating . Berkeley, CA: 10 Speed Press.
Tessina, T. 1998. The Unofﬁcial Guide to Dating Again . New York: Macmillan.
Interviews
Fry, R. 2007. 101 Great Answers to the Toughest Interview Questions, 5th ed . Clifton Park, NY:
Thomson Delmar Learning.
McKay, D.R. 2004. The Everything Practice Interview Book: Be Prepared for Any Question.  Avon,
MA: Adams Media Corporation.
Stein, M. 2003. Fearless Interviewing: How to Win the Job by Communicating with Conﬁdence . New
York: McGraw-Hill.
Public Speaking and Presentations
Kosslyn, S.M. 2007. Clear and to the Point: 8 Psychological Principles for Compelling PowerPoint
Presentations . New York: Oxford.
MacInnis, J.L. 2006. The Elements of Great Public Speaking: How To Be Calm, Conﬁdent, and
Compelling.  Berkeley, CA: 10 Speed Press.
McClain, G.R. 2007. Presentations: Proven Techniques for Creating Presentations that Get Results , 2nd
ed. Avon, MA: Adams Media Corporation.


ed. Avon, MA: Adams Media Corporation.
Monarth, H., and L. Kase. 2007. The Conﬁdent Speaker: Beat Your Nerves and Communicate at Your
Best in Any Situation . New York: McGraw-Hill.
Morrisey, G.L., T.L. Sechrest, and W.B. Warman. 1997. Loud and Clear: How to Prepare and
Deliver Effective Business and Technical Presentations, 4th ed. Reading, MA: Addison-Wesley.
Other Communication Skills
Bolton, R. 1979. People Skills . New York: Simon & Schuster.
Davis, M., K. Paleg, and P. Fanning. 2004. The Messages Workbook: Powerful Strategies for Effective
Communication at Work & Home . Oakland, CA: New Harbinger.
Fleming, J. 1997. Become Assertive ! Kent, United Kingdom: David Grant Publishing.
Garner, A. 1997. Conversationally Speaking: Testing New Ways to Increase Your Personal and Social
Effectiveness, 3rd ed. Los Angeles: Lowell House.


Recommended Readings
241Honeychurch, C., and A. Watrous. 2003. Talk to Me: Conversation Tips for the Small-Talk
Challenged . Oakland, CA: New Harbinger.
McKay, M., M. Davis, and P. Fanning. 1995. Messages: The Communication Skills Book, 2nd ed.
Oakland, CA: New Harbinger.
Patterson, R.J. 2000. The Assertiveness Workbook: How to Express Your Ideas and Stand Up for Yourself
at Work and in Relationships . Oakland, CA: New Harbinger.
ANXIETY DISORDERS AND COGNITIVE
BEHAVIOR THERAPY: SELF-HELP BOOKS
Antony, M.M., and R.E. McCabe. 2004. 10 Simple Solutions to Panic: How to Overcome Panic
Attacks, Calm Physical Symptoms, and Reclaim Your Life . Oakland, CA: New Harbinger.
Antony, M.M., and R.P. Swinson. 2008. When Perfect Isn’t Good Enough: Strategies for Coping with
Perfectionism, 2nd ed. Oakland, CA: New Harbinger.
Bieling, P.J., and M.M. Antony. 2003. Ending the Depression Cycle: A Step-by-Step Guide for
Preventing Relapse. Oakland, CA: New Harbinger.
Bourne, E.J. 2005. The Anxiety and Phobia Workbook, 4th ed . Oakland, CA: New
Harbinger.
———. 2003. Coping with Anxiety: 10 Simple Ways to Relieve Anxiety, Fear & Worry.  Oakland,
CA: New Harbinger.


CA: New Harbinger.
Burns, D.D. 1999. The Feeling Good Handbook, Revised Edition . New York: Plume.
Butler, G., and T. Hope. 2007. Managing Your Mind: The Mental Fitness Guide, 2nd ed. New
York: Oxford.
Davis, M., E.R. Eshelman, and M. McKay. 2008. The Relaxation and Stress Reduction  Workbook,
6th ed. Oakland, CA: New Harbinger.
Greenberger, D., and C.A. Padesky. 1995. Mind Over Mood: Change How You Feel by Changing
the Way You Think . New York: Guilford.
Gyoerkoe, K.L., and P.S. Wiegartz. 2006. 10 Simple Solutions to Worry: How to Calm Your Mind,
Relax Your Body, & Reclaim Your Life . Oakland, CA: New Harbinger.
Hyman, B.M., and C. Pedrick. 2005. The OCD Workbook: Your Guide to Breaking  Free from
Obsessive-Compulsive Disorder, 2nd ed. Oakland, CA: New Harbinger.
McKay, M., M. Davis, and P. Fanning. 2007. Thoughts and Feelings: Taking Control of Your Moods
and Your Life, 3rd ed. Oakland, CA: New Harbinger.
Zuercher-White, E. 1997. An End to Panic: Breakthrough Techniques for Overcoming  Panic Disorder,
2nd ed. Oakland, CA: New Harbinger.


The Shyness & Social Anxiety Workbook
242SOCIAL ANXIETY: BOOKS FOR PROFESSIONALS
Antony, M.M., and K. Rowa. 2008. Social Anxiety Disorder: Psychological Approaches to Assessment
and Treatment . Göttingen, Germany: Hogrefe.
Beidel, D.C., and S.M. Turner. 2007. Shy Children, Phobic Adults: Nature and Treatment of Social
Anxiety Disorder, 2nd ed. Washington, DC: American Psychological Association.
Crozier, W.R., and L.E. Alden, eds. 2005. The Essential Handbook of Social Anxiety for Clinicians .
Hoboken, NJ: Wiley.
Heimberg, R.G., and R.E. Becker. 2002. Cognitive-Behavioral Group Therapy for Social Phobia:
Basic Mechanisms and Clinical Strategies . New York: Guilford.
Hofmann, S.G. 2008. Cognitive-Behavior Therapy of Social Phobia: Evidence-Based and Disorder
Speciﬁc Treatment Techniques . New York: Routledge.
Hofmann, S.G., and P.M. DiBartolo. 2001. From Social Anxiety to Social Phobia: Multiple
Perspectives . Needham Heights, MA: Allyn and Bacon.
Hope, D.A., R.G. Heimberg, and C.L. Turk. 2006. Managing Social Anxiety: A Cognitive
Behavioral Therapy Approach (Therapist Guide) . New York: Oxford.
Kearney, C.A. 2005. Social Anxiety and Social Phobia in Youth: Characteristics, Assessment, and
Psychological Treatment . New York: Springer.
Stravynski, A. 2007. Fearing Others: The Nature and Treatment of Social Phobia . New York:


Cambridge.
ANXIETY DISORDERS AND
COGNITIVE BEHAVIOR THERAPY:
BOOKS FOR PROFESSIONALS
Andrews, G., R. Crino, M. Creamer, C. Hunt, L. Lampe, and A. Page. 2002. The Treatment
of Anxiety  Disorders: Clinician’s Guide and Patient Manuals, 2nd ed. New York: Cambridge.
Antony, M.M., and D.H. Barlow, eds. 2002. Handbook of Assessment, Treatment Planning,
and Outcome Evaluation: Empirically Supported Strategies for Psychological Disorders . New York:
Guilford.
Antony, M.M., and M.B. Stein. 2008. Oxford Handbook of Anxiety and Related Disorders . New
York: Oxford University Press.
Antony, M.M., and R.P. Swinson. 2000. Phobic Disorders and Panic in Adults: A Guide to Assessment
and Treatment . Washington, DC: American Psychological Association.
Antony, M.M., D.R. Ledley, and R.G. Heimberg, eds. 2005. Improving Outcomes and Preventing
Relapse in Cognitive Behavioral Therapy. New York: Guilford.


Recommended Readings
243Antony, M.M., S.M. Orsillo, and L. Roemer, eds. 2001. Practitioner’s Guide to Empirically-Based
Measures of Anxiety . New York: Springer.
Barlow, D.H. 2002. Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic,  2nd
ed. New York: Guilford.
———., ed. 2008. Clinical Handbook of Psychological Disorders, 4th ed. New York: Guilford.
Beck, A.T., and G. Emery. 1985. Anxiety Disorders and Phobias: A Cognitive Perspective.  New
York: Basic Books.
Beck, J.S. 1995. Cognitive Therapy: Basics and Beyond.  New York: Guilford.
———. 2005. Cognitive Therapy for Challenging Problems: What To Do When the Basics Don’t Work .
New York: Guilford.
Bernstein, D.A., T.D. Borkovec, and H. Hazlett-Stevens. 2000. New Directions in Progressive
Relaxation Training: A Guidebook for Helping Professionals . Westport, CT: Praeger.
Bieling, P.J., R.E. McCabe, and M.M. Antony. 2006. Cognitive Behavioral Therapy in Groups .
New York: Guilford.
Eifert, G.H., and J.P. Forsyth. 2005. Acceptance and Commitment Therapy for Anxiety Disorders:
A Practitioner’s Treatment Guide to Using Mindfulness, Acceptance, and Values-Based Behavior Change
Strategies . Oakland, CA: New Harbinger.
Kase, L., and D. Ledley. 2007. Anxiety Disorders . Hoboken, NJ: Wiley.


Miller, W.R., and S. Rollnick. 2002. Motivational Interviewing: Preparing People for Change,  2nd
ed. New York: Guilford.
Orsillo, S.M., and L. Roemer, eds. 2005. Acceptance- and Mindfulness-Based Approaches to Anxiety:
Conceptualization and Treatment . New York: Springer.
Richard, D.C.S., and D. Lauterbach. 2007. Handbook of Exposure Therapies . New York:
Academic Press.
Wright, J.H., M.R. Basco, and M.E. Thase. 2006. Learning Cognitive-Behavior Therapy: An
Illustrated Guide.  Washington, DC: American Psychiatric Press.
VIDEO RESOURCES
Albano, A.M. 2006. Shyness and Social Phobia . DVD. Washington, DC: American
Psychological Association.
Rapee, R.M. 1999. I Think They Think … Overcoming Social Phobia. DVD or VHS. New York:
Guilford.


National and International
Associations Providing
Referrals
NATIONAL ASSOCIATIONS (UNITED STATES)
Note that most of these associations offer information for ﬁnding therapists and other
resources in the United States and Canada, and several offer information on resources
in other countries.
Anxiety Disorders Association of America
8730 Georgia Ave., Suite 600
Silver Spring, MD 20910
USA
Tel: 1-240-485-1001
Fax: 1-240-485-1035
Web: www.adaa.org
UÊAnnual conference (for professionals and consumers)
UÊConsumer memberships and professional memberships
UÊInformation on support groups in the United States, Canada, South Africa,
Mexico, and Australia


The Shyness & Social Anxiety Workbook
246UÊNames of professionals who treat anxiety disorders in the United States,
Canada, and elsewhere
Association for Behavioral and Cognitive Therapies
305 Seventh Ave., 16th Floor
New York, NY 10001-6008
USA
Tel: 1-212-647-1890
Fax: 1-212-647-1865
Web: www.abct.org
UÊProfessional memberships only, but offers referrals to consumers
UÊFind a therapist: http://abct.org/members/directory/ﬁnd  a therapist.cfm
Academy of Cognitive Therapy
One Belmont Ave., Suite 700
Bala Cynwyd, PA 19004-1610
USA
Tel: 1-610-664-1273
Fax: 1-610-664-5137
E-mail: info@academyofct.org
Web: www.academyofct.org
UÊProfessional memberships only, but offers referrals for consumers to certi -
ﬁed cognitive therapists
American Academy of Cognitive and Behavioral Psychology
Attn: E. Thomas Dowd, Ph.D., ABPP
Department of Psychology
Kent State University
Kent, OH 44242
USA
Tel: 1-330-672-7664
Fax: 1-330-672-3786
E-mail: edowd@kent.edu
Web: www.americanacademyofbehavioralpsychology.org
UÊProfessional memberships only, but offers referrals for consumers to board -
certiﬁed psychologists in cognitive behavioral psychology www.american
academyofbehavioralpsychology.org/AABP/FellowDirectory.htm


National and International Associations Providing Referrals
247Freedom From Fear
308 Seaview Ave.
Staten Island, NY 10305
USA
Tel: 1-718-351-1717, ext. 24
Web: www.freedomfromfear.org
E-mail: help@freedomfromfear.org
UÊNational nonproﬁt advocacy organization for people with anxiety disorders
and depression
UÊNewsletter, blogs, bookstore
UÊInformation on support groups and other resources
American Psychological Association
750 First St., N.E.
Washington, DC 20002-4242
USA
Tel: 1-800-374-2721
Web: www.apa.org
UÊProfessional memberships only, but offers referrals to consumers
UÊReferral line: 1-800-964-2000
UÊFind a psychologist: http://locator.apa.org/
American Psychiatric Association
APA Answer Center
1000 Wilson Blvd., Suite 1825
Arlington, VA 22209
USA
Tel: 1-888-35-PSYCH or 1-703-907-7300
E-mail: apa@psych.org
Web: www.psych.org
UÊProfessional memberships only, but offers referrals to consumers


The Shyness & Social Anxiety Workbook
248INTERNATIONAL ASSOCIATIONS
Anxiety Disorders Association of Canada
ADAC/ACTA
P.O. Box 117
Station Cote St-Luc
Montreal, QC H4V 2Y3
Canada
Tel: 1-514-484-0504 or 1-888-223-2252
Fax: 1-514-484-7892
E-mail: contactus@anxietycanada.ca
Web: www.anxietycanada.ca
UÊConsumer memberships and professional memberships
UÊWebsite provides links to other sites with referral options in Canada
International Association for Cognitive Psychotherapy
Web: www.cognitivetherapyassociation.org
UÊProfessional memberships only, but offers referrals for consumers to cogni -
tive therapists: http://www.cognitivetherapyassociation.org/refhome.aspx
British Association for Behavioural and Cognitive Psychotherapies
Victoria Buildings
9–13 Silver Street
Bury  BL9 0EU
United Kingdom
Tel: 0161 797 4484
Fax: 0161 797 2670
E-mail: babcp@babcp.com
Web: www.babcp.com
UÊProfessional memberships only, but website includes a “ﬁnd a therapist”
feature for consumers.
Australian Association for Cognitive and Behaviour Therapy
Web: www.aacbt.org
UÊProfessional memberships only, but website includes a list of CBT practitio -
ners for consumers (click on the “state branches” link at the top, and then
click the link near the bottom of the list).


Internet Resources
Although the information in this section was up to date when this book went to press,
Web pages come and go, and addresses for Internet resources change frequently. For
additional information on Internet resources, we suggest doing a search using keywords
such as social phobia, social anxiety, and shyness. Note that although we have screened
each of these sites, we have not reviewed them in detail and cannot take responsibility
for the accuracy of the information they contain.
Anxieties.com
www.anxieties.com
UÊA very informative anxiety self-help site run by the Anxiety Disorders
Treatment Center (and Dr. R. Reid Wilson) in Durham, NC
Anxiety-Panic.com
www.anxiety-panic.com
UÊA search engine for anxiety-related links
Anxiety Disorders Association of America
www.adaa.org
UÊNational association for professionals and consumers with an interest in
anxiety disorders
CPA Clinical Practice Guidelines for the Management of Anxiety Disorders
http://ww1.cpa-apc.org:8080/Publications/CJP/supplements/july2006/anxiety  guide
lines 2006.pdf


The Shyness & Social Anxiety Workbook
250UÊDownloadable treatment guidelines published in 2006 by the Canadian
Psychiatric Association
Internet Mental Health
www.mentalhealth.com
UÊComprehensive website with information on mental health issues
NIMH Anxiety Disorders Brochure
http://www.nimh.nih.gov/health/publications/anxiety-disorders/summary.shtml
UÊDownloadable brochure on anxiety disorders published in 2007 by the
National Institute of Mental Health
Shyness Home Page
www.shyness.com
UÊProvides links to information about shyness
Resources for Shy People
www.gordoni.com/shy
UÊA list of resources compiled by self-identiﬁed shy person, Gordon Irlam
(Gordoni)
Social Anxiety Support
www.socialphobia.org.nz
UÊA New Zealand–based site on social anxiety and related topics
Social Phobia/Social Anxiety Association
www.socialphobia.org
UÊSite for a nonproﬁt organization focused on social phobia and social
anxiety
Social Phobia World
www.socialphobiaworld.com
UÊA place for online forums and chats about social phobia


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Martin M. Antony, Ph.D.,  is professor of psychology at Ryerson University in Toronto,
ON, and director of research at the Anxiety Treatment and Research Centre at St.
Joseph’s Healthcare in Hamilton, ON. He is also president-elect of the Canadian
Psychological Association. He has published twenty-four books and more than 100 sci -
entiﬁc papers and book chapters in the areas of cognitive behavior therapy and anxiety
disorders. He has received early career awards from the Society of Clinical Psychology
(American Psychological Association), the Canadian Psychological Association, and the
Anxiety Disorders Association of America, and is a fellow of the American and Canadian
Psychological Associations. He is past president of the Anxiety Disorders Special
Interest Group of the Association for Behavioral and Cognitive Therapies (ABCT) and
has been program chair for the ABCT annual convention. He is actively involved in
clinical research in the area of anxiety disorders, teaching, and education, and maintains
a clinical practice. Visit him online at www.martinantony.com.
Richard P. Swinson, MD, is professor emeritus and past chair of the Department of
Psychiatry and Behavioural Neurosciences at McMaster University in Hamilton, ON,
Canada.  He is also medical director of the Anxiety Treatment and Research Centre
and past psychiatrist-in-chief at Joseph’s Healthcare, also in Hamilton. He is a fellow
of the Royal College of Physicians and Surgeons of Canada, the American Psychiatric
Association, and the Royal College of Psychiatrists UK. He was awarded an inaugu -
ral fellowship of the Canadian Psychiatric Association in 2006. His research interests
lie in the theory, assessment and treatment of anxiety disorders, particularly obsessive-
compulsive disorder and social anxiety disorder.  He has published more than 180 peer-


compulsive disorder and social anxiety disorder.  He has published more than 180 peer-
reviewed papers, thirty book chapters, and eight books. Dr. Swinson has held numerous
research grants since 1966 and has been an invited speaker at many conferences around
the world on anxiety disorders and substance use disorders. He also chaired the steer -
ing committee for the Canadian Anxiety Treatment Guidelines Initiative, leading to the
publication of Canadian Clinical Practice Guidelines for the Management of Anxiety
Disorders in 2006.


Hogrefe & Huber Publishers · 30 Amberwood Parkway · Ashland, OH 44805
Tel: (800) 228- 3749 · Fax: (419) 281- 6883 · E-Mail: custser v@hogrefe.comMartin M. Antony, Karen Rowa
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University of Central Florida, Orlando, FL“[The authors] are to be congratulated for putting together a concise, practical,
eminently readable primer on diagnosis and treatment of SAD. Yes, the advice is
evidence-based, but it is also grounded in years of experience treating patients…
It is required reading for any therapist seeking to broaden or sharpen their
expertise in this area. ”
Murray B. Stein, MD, MPH, Professor, Department of  Psychiatry, and Director,
Anxiety & Traumatic Stress  Disorders Program, University of California San Diego, CA
Call toll free 800 228-3749  to order or visit www.hogrefe.com  for more detailsAlso by this Author:
Table of Contents
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Procedures and Documentation
2 Psychological Approaches to Understanding Social Anxiety Disorder: (309284=4?0"9/06916,;5,8/*066<G(309284=4?003,?49;,6"9/06


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MARTIN M. ANTONY , PH.D.
RICHARD P . SWINSON, MDPROVEN, STEP-BY-STEP TECHNIQUES
FOR OVERCOMING YOUR FEARA NEW HARBINGER SELF-HELP WORKBOOKTheShyness & Social Anxiety Workbook
SECOND EDITIONIs Fear of Social Situations Keeping You from Living the Life You Want?
There’s nothing wrong with being shy. But if social anxiety keeps you from forming relationships with others,
advancing in your education or your career, or carrying on with everyday activities, you may need to confront
your fears to live an enjoyable, satisfying life. This new edition of The Shyness and Social Anxiety Workbook  offers a
comprehensive program to help you do just that.
As you complete the activities in this workbook, you’ll learn to:
UÊÊ`ÊÞÕÀÊÃÌÀi}ÌÃÊ>`ÊÜi>iÃÃiÃÊÜÌÊ>ÊÃiviÛ>Õ>ÌÊÊUÊÊ
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Information about therapy, medications, and other resources is also included. After completing this program,
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“This volume, written by a team composed of a psychologist and a psychiatrist, is an outstanding
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PH.D., clinical professor in the department of psychology at the University of California, Berkeley


PH.D., clinical professor in the department of psychology at the University of California, Berkeley
“This is a must-read for persons suffering with social anxiety.”  —MICHELLE G. CRASKE, PH.D., professor
of psychology at the University of California, Los Angeles
MARTIN M. ANTONY , PH.D., is professor of psychology at Ryerson University in T oronto, director of research at the
Anxiety T reatment and Research Centre at St. Joseph’s Healthcare in Hamilton, ON, and president-elect of the Canadian
Psychological Association. He lives in T oronto, ON, Canada.
RICHARD P . SWINSON, MD, is professor emeritus and past chair of the
Department of Psychiatry and Behavioural Neurosciences at McMaster Uni-
versity in Hamilton, ON, Canada. He is also medical director of the Anxiety
T reatment and Research Centre at Joseph’s Healthcare, also in Hamilton.
Swinson lives in T oronto, ON, Canada.The Shyness &Ê-V>ÊÝiÌÞÊ Workbook                                                                                SELF -HELP
newharbinger publications, inc.
www.new harbinger .com
ANTONY
SWINSON-
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