The Shyness & Social Anxiety Workbook
76Now that you have identiﬁed speciﬁc treatments you have tried in the past, the next 
step is to understand why a treatment was ineffective or only partially effective, if that 
was your experience. Listed below are some of the reasons why psychological treatments 
and medications are occasionally not helpful.
Why Psychological Treatments Sometimes Don’t Help
UÊThe therapy is an ineffective treatment for social anxiety. Many types of 
psychotherapy have never been studied for the treatment of social anxiety, 
and others have been found to be of little beneﬁt. (Cognitive behavioral 
therapy is the best-studied approach and is well supported.)
UÊThe therapist is inexperienced either with the type of therapy being offered 
or the treatment of shyness and social anxiety, in particular.
UÊThe frequency and intensity of exposure practices is too low. If you practice 
exposure to social situations too infrequently, you will be less likely to see 
the desired results.
UÊThe treatment does not last long enough. You may not have beneﬁted from 
previous therapy if you dropped out of treatment before positive results 
could be seen.
UÊAn individual expects the treatment to be ineffective. There is evidence that 
a person’s expectations can affect the outcome of psychotherapy (Safren, 
Heimberg, and Juster 1997).
UÊThe person does not comply with the treatment. If you miss sessions, arrive 
late for sessions, or don’t complete homework, therapy is less likely to be 
effective.
UÊThere are other problems or stresses in the person’s life that interfere with 
treatment (for example, severe depression, alcohol abuse, stressful job,