Research question
What treatments have evidence for social anxiety disorder in adults?
What the evidence suggests
Social anxiety disorder responds to both psychological and medication treatment, and a large network meta-analysis has compared the options directly. A 2014 network meta-analysis in Lancet Psychiatry by Mayo-Wilson and colleagues found that individual CBT was the most effective intervention for social anxiety disorder, with effects that were larger and appeared more durable than medication. SSRIs and SNRIs were also more effective than placebo and remain a recommended option, particularly for patients who prefer medication or cannot access CBT.
Within CBT, exposure to feared social situations is central. Treatment helps a person test their fearful predictions about social judgment and gather evidence that contradicts them. Group CBT has evidence as well, and several trials find group formats produce effects broadly comparable to individual CBT, which matters for access because group delivery can reach more people.
Practical interpretation
For social anxiety disorder, CBT with exposure is a strong first-line choice, and SSRIs and SNRIs are also first-line. The network meta-analysis evidence pointing to CBT's durability is one consideration among several, alongside patient preference, severity, and access to a trained therapist. Treatment decisions belong with a clinician.
For the reader-facing reference explainer that pairs with this evidence review, see Shrinkopedia's encyclopedia entry on social anxiety disorder.
What the evidence doesn't prove
The evidence doesn't show that CBT works for every patient, and dropout occurs. It doesn't establish the best treatment for a specific individual. The finding that CBT may be more durable than medication comes from comparing groups; it doesn't predict any one person's long-term course.
Sources
How to cite this page
Short
AnxietyResearch.org (2026). What the evidence says about Social Anxiety Disorder. Medically reviewed by Shariq Refai, MD, MBA. https://anxietyresearch.org/evidence-summaries/social-anxiety-disorder/
APA
Refai, S. (2026, May 18). What the evidence says about Social Anxiety Disorder. AnxietyResearch.org. https://anxietyresearch.org/evidence-summaries/social-anxiety-disorder/
MLA
Refai, Shariq. "What the evidence says about Social Anxiety Disorder." AnxietyResearch.org, 18 May 2026, https://anxietyresearch.org/evidence-summaries/social-anxiety-disorder/.
Related reading
What the evidence says about Exposure Therapy
Exposure-based therapy produces large effect sizes for specific phobias and panic disorder. Inhibitory learning frameworks now guide protocol design.
What the evidence says about CBT for Anxiety
Cognitive behavioral therapy shows moderate to large effects across generalized anxiety, social anxiety, panic, and specific phobias in meta-analyses.
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