Can Therapy Change Brains of People with Social Anxiety?

A woman sitting alone on outside stairsIn a small research trial published in Translational Psychiatry, just nine weeks of online cognitive behavioral therapy (CBT) decreased brain volume in participants experiencing social anxiety.

According to the Anxiety and Depression Association of America, about 15 million Americans experience social anxiety, which produces excessive fear of embarrassment, judgment, and shame in social situations. Many people with social anxiety feel too anxious to seek help, with 36% experiencing symptoms for 10 years or longer before pursuing treatment. Social anxiety often begins early in life, with an average onset age of 13.

Online CBT for Social Anxiety

Swedish researchers from Linköping University led the study, with the assistance of colleagues from other Swedish universities. The team worked with 26 people whose diagnostic interviews and answers to online questionnaires met criteria for social anxiety. Though eight participants were taking selective serotonin reuptake inhibitors (SSRI) to control their anxiety, their dose was stable for at least three months prior to the study. Each participant underwent a magnetic resonance imaging (MRI) study before and after the study.

Each participant received a weekly online CBT session for nine weeks. CBT helps participants to understand how their thoughts affect their behaviors and to correct inaccurate or unhealthy thoughts. At the end of each session, the online therapist provided participants with written feedback. Participants, on average, completed eight of nine sessions, and were required to complete multiple choice tests about CBT each week. The tests required 95% accuracy to move to the next session.

MRI scans at the end of the study showed a decrease in both brain volume and activity in the amygdala, a brain region associated with memory, emotional regulation, and decision-making. Participants also reported a decrease in symptoms of social anxiety.

This study is just one among a group of studies the authors hope to produce. Because the study is relatively small, further research is necessary to better understand the psychological and biological effects of treatment.


  1. Brain volume changes after CBT. (2016, February 3). Retrieved from
  2. Månsson, K. N., Salami, A., Frick, A., Carlbring, P., Andersson, G., Furmark, T., & Boraxbekk, C. (2016). Neuroplasticity in response to cognitive behavior therapy for social anxiety disorder. Translational Psychiatry, 6(2). doi:10.1038/tp.2015.218
  3. Social anxiety disorder. (2015, June). Retrieved from

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  • Leave a Comment
  • Trina

    February 4th, 2016 at 10:50 AM

    Sure… why not?
    I mean, if they really want to make a change and see that this behavior is harmful to them, then I would think that it would at least be worth a try

  • Calvin

    February 6th, 2016 at 6:59 AM

    I do really like the thought of having online treatment options for those with social anxiety. I mean that anxiety in and of itself could keep many people from ever seeking out therapy for the fears that they have that are associated with their illness. Having online options may give them the chance to seek out all of their therapy options without feeling overwhelmed by meeting someone new face to face and even having to leave the house.

  • Peter Strong

    February 10th, 2016 at 8:55 AM

    Social anxiety is a learned habit caused by becoming identified with a set of emotional and cognitive reactions that are triggered by external and internal experiences. We can change these automatic internal habitual reactions through CBT or Mindfulness Therapy, both of which work extremely well online over Skype.
    Boulder Center for Online Mindfulness Therapy and author of ‘The Path of Mindfulness Meditation.’

  • jasper

    April 19th, 2018 at 10:38 AM

    There’s numourous ways to deal with social anxiety. Some require therapy. Some don’t. Check out this video that shows 7 ways to beat the condition.

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