The therapeutic relationship between you and your therapist is very important. You need to be able to work together to address the various thoughts, emotions and behaviours that keep your anxiety going.

There is rarely a “quick fix” for social anxiety so it’s important to recognise when things aren’t going well – and why. CBT is often described as a very active therapy. This means it is more than talking about your difficulties. There are often practical tasks to carry out, sometimes in sessions and often between sessions as homework. Regular and consistent practice is one of the most important factors in using CBT. This can be challenging as it may initially increase anxiety.

However, sometimes other factors may be causing the issues. Perhaps the relationship between you and your therapist may not be working well or other life issues are complicating therapy. This page tries to support you in addressing such issues.

If you are with an NHS Talking therapist and things aren’t going well, you could write a letter or email to your current therapist. It is clearly challenging, especially with social anxiety, to raise difficult issues but a good therapist should consider your concerns and give you feedback from their clinical perspective. Sometimes talking about this in the appointment can be helpful for both parties involved, as difficult as it may seem. Try and be honest – a good therapist may be able to adapt some elements of the therapy. Therapy can be challenging, but most therapists will be able to adapt certain elements of it to your individual needs.

Attending and engaging in therapy can be an additional source of stress, as it involves arranging appointments, taking time out to attend and having at times difficult conversations about your thoughts and feelings. If you are unwell or very busy, it may be worth thinking about whether now is the right time to continue with therapy.

The reality of the NHS may mean that if you are discharged, you will need to re-refer again at a time you are able to commit to regular therapy sessions. It is likely this may involve waiting lists. It may be worth discussing this with your therapist, or someone who works for your NHS talking therapies service to find out more about this including how to refer and approximate time frames. You can always ask if it is possible to see a different therapist, or some people may find it helpful to continue with the individual they previous met with.

Private therapy generally offers more flexibility – such as appointments outside of standard ‘working hours’. This can also depend on the availability of therapists with the right qualifications and experience. If things are still not going well, you could ask for a break. This may be more possible when working with a private therapist than within the NHS.