The Shyness & Social Anxiety Workbook
44Fear Scale
0 10 20 30 40 50 60 70 80 90 100
None Mild Moderate Extreme Very 
Extreme
Avoidance Scale
0 10 20 30 40 50 60 70 80 90 100
Never  
AvoidRarely  
AvoidSometimes  
AvoidOften  
AvoidAlways  
Avoid
Feared Social Situations Worksheet
Interpersonal Situations (interacting with others)
Fear Avoidance Item
  Asking someone out on a date
  Starting a conversation with a classmate or coworker
  Going to a party
  Having friends over for dinner
  Being introduced to new people
  Talking on the telephone with a friend
  Talking on the telephone with a stranger
  Expressing a personal opinion (for instance, expressing 
your views about a movie that you saw recently or a book 
that you’ve read)
  Being interviewed for a job
  Being assertive (such as refusing an unreasonable request)
  Returning an item to a store 
  Sending back food in a restaurant
  Making eye contact
  Other (specify)                  
  Other (specify)                  
  Other (specify)