What is social anxiety at work?

It is a persistent fear of being judged, criticised or found lacking by colleagues, managers or clients. It often shows up in meetings, presentations, video calls and everyday exchanges like small talk, and it tends to lead to avoidance, over-preparation or replaying conversations afterwards.

Does CBT actually work for social anxiety?

CBT is the psychological treatment recommended in NICE guidance for social anxiety disorder. It works by testing the thoughts that drive the fear, reducing safety behaviours that keep it going, and using planned exposure to feared situations to build more accurate expectations.

How long does CBT for social anxiety usually take?

This varies from person to person and depends on what is being worked on. A psychologist will discuss likely timescales with you directly once they understand your specific situation.

Can CBT help with anxiety about video calls specifically?

Yes. Video calls raise particular triggers, such as watching your own face on screen or worrying about being on mute at the wrong moment. CBT can address these directly, including through graded practice with cameras and specific calls.

What is the difference between shyness and social anxiety at work?

Shyness is a personality trait that does not usually stop someone functioning day to day. Social anxiety involves a level of fear and avoidance that gets in the way of tasks like speaking up in meetings, giving feedback or attending team events, and it tends to persist rather than ease with familiarity.

Do I need a diagnosis to start CBT for social anxiety?

No. Many adults seek CBT for social anxiety symptoms that affect their working life without a formal diagnosis. An initial assessment looks at what is happening and what would be useful to work on.

Sep 9, 2026

Social anxiety at work: what CBT actually targets

Social anxiety at work centres on a fear of being judged, watched or found lacking in front of colleagues, and cognitive behavioural therapy (CBT) targets three linked parts of that fear: the thoughts that fuel it, the safety behaviours that keep it going, and the physical symptoms that show up in meetings, calls and everyday exchanges.

For some people it shows up before a presentation, as a tight chest and a mind that goes blank. For others it is quieter: staying silent in meetings rather than risk saying the wrong thing, avoiding the kitchen at lunch, or drafting and redrafting a short email several times before sending it. Video calls bring their own pressure, watching your own face on screen while trying to sound competent. None of this means someone is bad at their job. It means their attention has narrowed onto how they might be seen, rather than on the task itself, and CBT starts by mapping exactly where that narrowing happens.

What CBT actually targets

The thoughts behind the fear

CBT looks closely at the specific thoughts that appear in feared situations at work, such as assuming a pause in conversation means people are bored, or that a neutral comment from a manager is a coded criticism. These thoughts often arrive as certainties rather than guesses. Part of the work is treating them as guesses that can be tested, rather than facts that must be managed around. A therapist will usually ask what evidence supports the thought and what else could explain the same situation, then help build a more accurate, more workable alternative.

Safety behaviours that keep it going

Safety behaviours are the small things people do to feel less exposed: rehearsing sentences before saying them, avoiding eye contact on video calls, over-preparing for meetings that do not need it, or letting colleagues speak first every time. They bring short-term relief, but they also stop a person finding out that the feared outcome would not actually happen. CBT identifies these behaviours one by one and works out which to reduce first, usually starting with whichever feels most manageable rather than the most frightening.

Replaying it afterwards

Many people with social anxiety at work spend more time reviewing a conversation after it ends than they spent having it, picking apart a sentence that came out wrong or a laugh that seemed off. This is called post-event processing, and it tends to lock in a distorted memory of what happened, since the review is done through the same anxious lens as the original event. CBT works on noticing when this replaying starts and building a way to step out of it deliberately.

Testing the fear in real situations

Talking through thoughts and behaviours only goes so far. NICE guidance on social anxiety disorder recommends CBT that includes structured exposure: trying out the situations that get avoided, in a planned and gradual way, and comparing what actually happens against the original prediction. At work, that might mean asking one question in a meeting where previously none were asked, sending an email without redrafting it five times, or joining a call with the camera on for part of it. Each attempt is agreed in advance and reviewed afterwards, so the person is collecting evidence rather than just gritting their teeth through it.

What CBT does not aim to do

CBT does not promise to remove nervousness completely, and it will not turn a naturally quiet person into someone who seeks out the spotlight. Some situations are genuinely harder for some people, and that is unlikely to change entirely. The aim is more specific: fewer avoided situations, more accurate predictions about how others are likely to react, and less time spent afterwards picking over what was said. Progress usually looks like a shorter, quieter version of the fear rather than its total disappearance.

Sessions typically begin by mapping which work situations are avoided or endured with high anxiety, then agreeing specific goals rather than a vague aim to “feel less anxious”. Between sessions there is usually practice to do, since the situations that matter most happen at work rather than in the therapy room. Progress is often uneven: a good week at meetings followed by a harder one is normal, and the work accounts for that rather than treating it as failure.

Support for adults in Greenwich and south east London

We are clinical psychologists for Greenwich and south east London, working online with adults, so sessions fit around a working week without adding a commute on top of it. Greenwich runs from the river at Cutty Sark up through Greenwich Park towards Blackheath, with the DLR and Southeastern services connecting the area to Charlton, Deptford, Lewisham, New Cross and Maze Hill as well as central London. We work with adults from Greenwich and the surrounding area, and we will update this site as the practice develops.

If things feel urgent

If anxiety is affecting your ability to function day to day, or you are struggling with thoughts of harming yourself, contact your GP, call NHS 111, or in an emergency call 999. The Samaritans can be reached free, any time, on 116 123.

What social anxiety at work looks like