Emotion-focused therapy for social anxiety (EFT-SA)
Abstract
Social anxiety (SA) is a common, disabling difficulty characterized by persistent fear of other people. After a brief clinical description, we present an emotion-focused therapy (EFT) theory of SA: We describe its developmental origins in experiences of social degradation, which result in primary emotional processes organized around a core sense of shame-ridden defective self. These give rise to secondary reactive anxiety that others will see the person’s defectiveness, organized around a coach/critic/guarding aspect of self that, in the process of trying to keep the person safe from exposure, inadvertently generates the emotional dysregulation characteristic of SA. Following this, we present a model and case example for working with SA via an emotional deepening process that begins with accessing secondary reactive anxiety of others in particular situations and then works backwards to accessing and activating primary maladaptive shame so that this emotion scheme can be restructured within a secure, accepting therapy relationship. We conclude with a brief summary of evidence for EFT-SA and some final thoughts about how working with this client population has changed our EFT practice.
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The rational model for the expected course of EFT for FCR specified four phases: making contact and beginning to explore FCR experiences; initial work with presenting secondary FCR processes; deepening: working on and resolving primary existential processes; and consolidation: maintenance or ending.
“This model specified four phases of work: 1. making contact and beginning to explore FCR experiences; 2. initial work with presenting secondary FCR processes (e.g., anxiety episodes); 3. deepening: working on and resolving primary existential processes (e.g., fear of death); 4. consolidation: maintenance (e.g., continuing intermittent support) or ending.”
From Developing an emotion‐focused therapy model for fear of cancer recurrence: A case‐level task analysis. (2024) · cites this paper as Elliott & Shahar,2017
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“deep brokenness or isolation), so that both can be transformed by experiencing and expressing adaptive emotions, such as self-soothing/ compassion, assertive/protective anger and connecting sadness (Goldman & Greenberg, 2014; Shahar, 2014).”
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Self and identity in social anxiety disorder
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Self-citationThe role of shame and self-criticism in social anxiety: a daily diary study in a nonclinical sample
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Self-citationAlmeida, S. N., Elliott, R., Silva, E. R., & Sales, C. M. D. (2024) · Counselling and Psychotherapy Research · doi:10.1002/capr.12624 · Cited by 2 · see citing works
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- Authors
- Elliott, R., & Shahar, B.
- Affiliations
- University of Strathclyde (GB)
- Reichman University (IL)
- Corresponding author
- Elliott, Robert
- Venue
- Person-Centered & Experiential Psychotherapies
- Publisher
- Informa UK Limited
- Published
- 2017-04-03
- Volume
- 16
- Issue
- 2
- Pages
- 140-158
- ISSN
- 1477-9757 (ISSN-L)
- 1752-9182
- OpenAlex
- W2620860623
- Cited by
- 45
- References
- 7
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 3 · 2023: 7 · 2022: 8 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 9 · 2012: 1
- FWCI
- 5.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Person-Centered & Experiential Psychotherapies (publishedVersion)
- Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (acceptedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- emotion-focused therapy, social anxiety, shame, social decline, emotional dysregulation, reactive anxiety, therapeutic relationship
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