The referral pathways guide
Read with intention
Meet the cliniciansThe fear isn’t people. It’s being seen getting it wrong.
Social anxiety is not shyness turned up. It is a specific, well-understood pattern with an equally specific treatment. If “just relax and be yourself” has never worked, that is not your failure.
Not quiet. Working very hard to look calm.
These are what people describe when they come to us about social anxiety. You do not need all of them for this page to be about you.
- You rehearse ordinary conversations beforehand, and replay them for hours afterwards looking for what you got wrong.
- You have turned down a job, a course, a party, and given a different reason.
- In a group you are watching yourself from the outside, which means you miss most of what is actually said.
- Blushing, shaking, sweating or a voice that goes thin, and the certainty that everyone has noticed.
- You have a set of small habits that get you through: the phone, the drink, the seat near the door, saying little.
- People describe you as quiet or aloof, and you know how much effort the quiet is costing.
- Sending an email, making a call or speaking in a meeting sits on your list for days.
- You have been told to just relax and be yourself, which has never once helped.
Not sure where to start? The Mind Health Check takes about ten minutes and points you to the right next step. If things feel urgent right now, our urgent help page has the numbers you need.
Individual CBT. The version built for this.
Cognitive behaviour therapy for social anxiety is first-line treatment, and it is not generic CBT with the word social in front. It targets two specific mechanisms, and both of them are things you are already doing to cope.
Attention, turned back outwards
Social anxiety runs on self-monitoring: watching your own performance instead of the conversation. The first practical skill is getting that attention back into the room, where the actual evidence is.
Dropping the safety behaviours
Gripping the glass, over-preparing, saying less, avoiding eye contact. Each one feels like it prevents disaster and each one prevents you from ever finding out that disaster was not coming. These come off deliberately, one at a time.
Experiments, not endurance
Not gritting your teeth through an ordeal. You name what you predict will happen, do the thing, and check what actually happened. The prediction is usually specific, and it is usually wrong, and finding that out is the mechanism.
When avoidance has cost you years
If the fear has already shaped a career or a decade, ACT sits alongside the CBT. It works on what you want your life to contain, not only on what you are afraid of.
This is one member of a family of protocols. See the full CBT list, or read more about anxiety treatment generally and specific phobias.
The first three sessions, honestly.
Nothing is sprung on you, and the first experiment is deliberately small.
- 1
The first session is a social situation
We know. You do not have to perform being fine in it. Telehealth is a completely reasonable place to start, and plenty of people do.
Session 1 - 2
We map your version of it
Which situations, what you predict happens in them, what you do to stop it, and what that costs you. This is the part that makes the rest specific rather than generic advice.
Sessions 1–2 - 3
You start testing, small
The first experiment is deliberately unimpressive. It has to be, because the point is evidence, not bravery. It builds from there at a pace you set.
From session 3
You will know the cost before you attend.
Asking about money is itself the kind of conversation this is about, so we put it in writing before your first session rather than making you raise it.
See fees- Medicare rebates apply with a Mental Health Treatment Plan from your GP.
- Telehealth is rebatable on the same terms as coming in, which helps if a first appointment is the hard part.
- No referral needed to book. A plan only changes what you pay.
Meet our clinicians
More ways we can help.
Check in with yourself.
Free, private tools to try before or alongside sessions. They are not a diagnosis.
Free · 5 to 10 min
Take the Mind Health Check
Short questionnaires, scored privately in your browser. We have ticked the ones most related to this page, and you can change them.
Fact sheet: Social anxiety
A plain-language guide with practical steps. Free to download.
Try this week
- In a conversation, notice where your attention goes, and bring it back to the other person.
- Choose one small social step this week, such as saying hello first.
- Drop one safety habit, such as rehearsing what you will say.
Need help now? Our urgent help page has who to call, day and night.
Things people ask before they book
Is this just shyness?
No. Shyness is a temperament: common, harmless, and not something that needs treating. Social anxiety disorder is a persistent fear of being judged that changes what you do: jobs not applied for, invitations declined, conversations rehearsed for hours and then replayed for hours more. The line is not how nervous you feel. It is how much of your life the fear is deciding.
I've tried exposure before and it didn't help. Why would this?
Because unstructured exposure often is not the active ingredient here. Enduring a situation while still monitoring yourself and still running your safety behaviours can leave the belief completely intact. You got through it, but only because you gripped the glass and said nothing. The cognitive model targets exactly those two things, which is what makes it different from being told to face your fears.
Will I have to do public speaking?
Only if that is a goal you choose. Experiments are built around what you actually want back: ordering coffee without rehearsing, staying past the first hour, disagreeing with a colleague out loud. Nothing is sprung on you and you set the pace. Some people do end up doing the talk. It is not the entry requirement.
Is there a version that is only about performance?
Yes. The performance-only subtype is real and narrower: presenting, performing, playing, speaking up formally, while ordinary conversation is fine. Worth saying at the first session, because it changes the plan.
How is this different from avoidant personality?
They overlap heavily and are often the same thing at different intensities. Social anxiety is fear focused on being judged in situations. Avoidant personality is a pervasive, long-standing sense of inadequacy that shapes relationships across a lifetime. The distinction is made at assessment, not from a website. See personality disorders if that sounds closer.
What about medication?
That is a conversation for your GP or a psychiatrist, not for us: we cannot prescribe. What we can say is that psychological treatment and medication are not alternatives you have to choose between, and your psychologist will work alongside whatever your doctor recommends.
Can I use a Mental Health Treatment Plan?
Yes. A Mental Health Treatment Plan from your GP gives you a Medicare rebate on individual sessions. You do not need one to book. It changes what you pay, not whether you can come. See fees and rebates.
Is telehealth as good as coming in?
Start small. Start here.
Tell us what’s going on and we’ll match you with a psychologist who works with social anxiety, usually after a free triage. No referral needed to begin.
