How Often Should You Go to Therapy for Social Anxiety Using Acceptance and Commitment Therapy?
Social anxiety can feel like a heavyweight, one that keeps you stuck in patterns of avoidance, self-criticism, and fear of judgment. Whether you are navigating a party, a work meeting, or even a casual social encounter, anxiety can make these moments feel unbearable. What if there was another way to approach this struggle, one that does not require eliminating anxiety entirely? Instead, we learn to live with it in a more accepting and less distracting way.
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Acceptance and Commitment Therapy (ACT) is an approach that is gaining popularity in the treatment of social anxiety. Unlike Cognitive Behavioral Therapy (CBT), which often focuses on "challenging" and changing negative thought patterns, ACT teaches individuals to accept their thoughts and feelings, make room for them, and still take action in line with their values. The beauty of ACT is that it empowers you to live a fuller life despite your anxiety instead of trying to get rid of it.
Psychological Flexibility for Social Anxiety
To explain what ACT teaches, let’s use the "cringe" which exemplifies social anxiety. The crunch closes you off; the doubt feels unsteady; and the subconscious and conscious avoidance separates us from the present moment. Learning and practicing the skills taught in ACT helps us feel the exact opposite. To feel receptive, grounded, and participating in life. Rather than react, we learn a new response to social anxiety.
For example, consider how long you've been trying to get rid of anxiety, yet that pesky sympathetic nervous system keeps kicking on even though you don't want it to. Maybe then, it's not that our brains need changing; it's our response to a healthy human nervous system that needs changing.
Nevertheless, we benefit from some grace early on while we become consistent with the new skills and approaches to experiences. Some people learn it's quite challenging to slow down and pay attention to the present moment. Simple is not the same as ease, after all. Yet, the more they practice, with professional support, the more steps they take. One day (and I don’t know what day that’ll be), we will suddenly stop, notice, and look back with gratitude at how much progress we'd made from our most challenging point.
So, if you are considering ACT for your social anxiety, you may be wondering: How often do I go to therapy? Like with any treatment, the frequency depends on several factors, such as your personal goals, how safe you feel with your therapist, the severity of your symptoms, and how quickly you start feeling empowered to make changes in your life. There are also variables about your stage of change that may impact therapy effectiveness. Let's explore how often you might want to go to therapy when using ACT to address social anxiety.
The Basics of ACT for Social Anxiety
ACT is built around the idea that fighting against painful thoughts and feelings (like social anxiety) often makes them worse. Instead of battling with your anxiety, ACT encourages you to embrace it and develop a more flexible, compassionate relationship with it. Develop new responses with (and I know this may sound impossible right now) self-compassion instead of always believing the inner critic. The goal is to reduce the struggle with your anxiety while increasing your ability to live according to your values, even when fear is present (aka the definition of being brave).
In ACT, you'll focus on six core processes:
1. Cognitive Defusion: "Learning to separate yourself from your thoughts so you don't get swept away by them." (Notice they come and go whether you want them to or not)
2. Acceptance: "Embracing your feelings rather than avoiding them so you can learn from them." (Lessons and values are waiting to be seen and not judged in the pain and fear)
3. Mindfulness: "Being present and aware, without judgment." (The only time we can make a change)
4. Self-as-Context: "Seeing yourself as more than your thoughts and feelings with respect to your intent." (Be curious and ask why, rather than what)
5. Values Clarification: "Identifying what truly matters to you." (A compass)
6. Committed Action: "Taking steps toward your values, even when anxiety is present." (Rubber meet road, road meet rubber)
Unlike CBT, which often focuses on restructuring thoughts to change feelings and behavior, ACT focuses on changing your relationship with your thoughts and emotions. Much like deepening a relationship with a friend or loved one, you learn to understand them in a more profound way and choose to respond to them intentionally with respect and compassion. You don't need to stop feeling anxious; you can learn how to feel it without it controlling your life.
Initial Phase: Weekly Sessions to Build Safety
When you first begin ACT, weekly therapy sessions are often recommended. This early stage is about learning the foundational skills of ACT, particularly mindfulness, defusion, and acceptance. These skills are critical in helping you shift your perspective on your anxiety.
During the initial sessions, you'll work with your therapist to understand how your mind works, learning to notice thoughts without getting caught up in them. Instead of seeing anxiety as something to push away, you'll begin to see it as a natural part of being human. You'll learn to sit with discomfort, which can be a game-changer regarding social anxiety.
Weekly sessions in this stage also allow you to start practicing acceptance in real-world situations. You might be asked to engage in small imagined exposures to social situations, not to eliminate anxiety but to sit with it and act in ways that are aligned with your values, like connecting with people, even when your anxiety is present.
This period of frequent therapy helps you integrate the core principles of ACT, which are vital for long-term success. You'll also have time to address any roadblocks or difficulties that arise as you move through the discomfort of social situations. Maybe there's a memory or two wanting to be noticed.
Middle Phase: Every Other Week as You Practice New Skills
Once you start to understand and apply ACT's tools, you may find that your anxiety is still there, but it is no longer controlling your life. In the middle phase of therapy, many people find that sessions every other week are sufficient.
At this stage, you'll be refining the skills you have learned. You might explore specific fears that come up in different social situations, uncover themes from the patterns you're now seeing, or dive deeper into clarifying your values. For example, you might want to connect with people in a more authentic way, but fear of judgment holds you back. Through ACT, you'll learn how to approach those situations with mindfulness and acceptance instead of trying to push away the anxiety.
You'll also likely begin to engage in more challenging exposures. Perhaps attending social events with the goal of being present, even if your anxiety doesn't magically disappear. You'll still feel anxious, though your ability to tolerate that anxiety will increase, and you will feel empowered to take actions that align with your deeper values. A growth mindset starts to become more frequent, and you focus on getting better within the process of facing fears rather than waiting for the day that the fears magically fade away.
The two-week interval between sessions allows you time to practice these skills between appointments while still having support to reflect on and adjust your approach.
Later Phase: Monthly Sessions for Maintenance and Growth
As you become more comfortable with ACT and your anxiety begins to feel more manageable, the frequency of therapy may decrease. Many people find that monthly check-ins are enough once they've integrated ACT's principles into their lives.
By this point, you've likely learned to live with your anxiety rather than trying to change or eliminate it. You've made progress in identifying what is most important to you, and you are taking steps toward living a life that is meaningful, even when anxiety shows up. Monthly sessions help maintain your momentum, allow you to check in on how things are going, and adjust strategies if new challenges arise.
In the later stages, therapy may focus more on personal growth, refining values, and taking action toward more complex or extensive goals, such as career changes, building deeper relationships, or expanding one's social circle. Sometimes, a stress response from a life change may increase social anxiety. Monthly support helps catch those earlier on before old patterns become more frequent.
Life's Ups and Downs: Flexibility Is Key
One of the strengths of ACT is its flexibility. Even after you've learned the basics, life events can bring up new challenges or moments of heightened anxiety. A new job, a shift in relationships, or changes in your personal life can trigger old patterns of social anxiety. During these times, consider returning to weekly or bi-weekly sessions to get back on track. However, you're also competent and may see the path forward, and simply venting in a safe space helped recenter you.
ACT encourages you to be flexible with yourself. If you need additional support, don't hesitate to adjust your therapy schedule to meet your current needs. It's a sign you're living a meaningful life, not shame or disappointment for "going backward."
The Journey Is Yours
The frequency of therapy is a personal choice, and it will change as you grow. What's most important is that you continue to move forward with compassion for yourself and a commitment to living a life aligned with your values. Let's consider that perhaps as you're reading this; you've had no therapy. Simply going once is progress! Going twice is even better!
Going is good enough. Whether you're meeting weekly to learn the tools of ACT or checking in monthly to celebrate your progress, what matters most is that you are not letting anxiety dictate your life. You are learning to embrace it, accept it, and live with it, and that is a powerful shift.
Remember, there's no rush; the first lesson may be to slow down and pay attention. Progress takes time, and each small step you take is a victory. Therapy is just one part of your journey, and the path you walk toward peace with your anxiety is uniquely yours. Be gentle with yourself and know that therapy is a supportive companion to help you create a life where social anxiety no longer holds the reins.