Can you do this therapy while doing CBT with a therapist in-person as well?


#1

I’m considering going to a therapist in real life to do CBT for my social anxiety just because I’m struggling to apply things on my own. HOwever, I feel like Dr. Richards really has a strong understanding of the disorder and that the handouts could still be good for me.

Would it be counterproductive to do to CBT’s at once? Has anyone else ever tried this?


#2

A question we get a lot here at the Social Anxiety Institute is if one should do the audio therapy series or see a therapist, OR if one should do the audio therapy series with a therapist / will a therapist use this audio therapy series or their own program? I think your question is similar to these.

If someone asks me if they should see a therapist OR do the series:
Seeing a therapist can be therapeutic in other ways. Just the act of going to see someone, being proactive, being able to discuss worries out loud and have rational feedback from a therapist - all those things are good. Are they necessary if someone does not have access to a therapist? No, not in my opinion, because the series is structured as if you were seeing a therapist (granted you don’t have the face to face aspect / group dynamic… but all in good time, take it step by step). And most of us aren’t fortunate enough to be near a therapist who understands this enough to know how to effectively treat it.
Now to the “OR” part of this - this is assuming that seeing a therapist is independent of doing some structured CBT program. There needs to be some structured program, CBT, brain learning therapy, structured with repetition daily. This is what you are doing now, right?, with the audio therapy series. So, when someone seems to indicate that they might see a therapist and not do “Overcoming Social Anxiety: Step by Step” then I ask them to ask the therapist what structured program the therapist provides. I think you all know by now that the real work of overcoming social anxiety is our daily practice, steady and persistent, building over time. The real work of change does not come in seeing a therapist once a week only to discuss the concepts. The real work for anyone here in our groups is not just the group time. Yes, that behavioral therapy is part of it, but the real work is still their daily therapy practice at home, etc. So whatever therapist you may go to, naturally you would want to know what they are doing for you to help you overcome social anxiety.

Likely when you ask a therapist they will be assuring. They will say they understand social anxiety and they will be able to help you. Okay, but how? With what? Then if they do have some experience, is their “program” structured step by step and fully aware of how deep this goes? Is there program more structured and cohesive than simple worksheets or workbooks? Are they using some other workbook out there? If so, what is it. Take a look. Decide for yourself if they are providing a structured program that truly understands the steps needed here.

I say the above because I’ve talked to plenty of therapists before coming to SAI. They all said they knew what to do for me. None had a structured plan. None really understood it. I hate to say that, but this is my experience. And I truly hope you can find good therapists and tell us about it so that we can share that information with others. We never get this feedback. NEVER. There used to be a few groups we heard of and a therapist in L.A. He has since retired and we don’t hear about any other active groups. We don’t get reviews from their members. Again, if you find a good therapist, please let us know.

So if I have not found another therapist with a good plan, a structured program, I don’t personally see our program as being in conflict with something that person doesn’t provide. The therapist could then use the audio therapy series with you. That could be perfect. You would be doing something socially proactive, support from a human being, while using what I know to be a good series for overcoming social anxiety.

But, will the therapist be willing to use this program? I hope so. Maybe? Maybe not. I would think that if you tell your therapist that you want their help to help you go through THIS audio therapy, then that therapist should say yes. After all, they’re getting paid to do their job. After all, you would think they should want to help you. Don’t be scared to speak up for your opinion. You are the client.

But here’s the thing that I have noticed, from some personal experience and from hearing from others’ experiences - many therapists aren’t that interested, it seems, at least not interested enough, to look into the audio therapy series enough to understand it. I guess that makes sense. You might have a therapist who believes their way is the right way. Okay, that’s a certain kind of person. You might also just have a therapist, and understandably so, who doesn’t have the time / won’t take the time to go through all of the series. You already know how much time and work and dedication it takes. Will another therapist really listen to the audio and go through the handouts like we do to fully understand this? I have not found that to be the case for me. Perhaps other therapists will and I hope so. Perhaps even they do not need to fully go through it all, as long as they are supportive and as long as they understand the concepts. This is not perfect, but it’s better than nothing right?

We rarely EVER get emails from other therapists who are interested in our work here. There are plenty of therapists/psychologists in this world, trying to help people with anxiety disorders. You might think at least a few would contact us about the series, to help their own clients, right? Not really. We did have one, and he was the therapist in L.A. And other informal groups of people with social anxiety reach out to us. But, licensed professionals beyond this do not contact us hardly ever about using the series. I’d be happy if they did. Now, a few months ago we received one email from a psychologist interested in using the audio therapy series. Good intentions and I’m happy to hear from such a person. I was surprised, however, by her questions about social anxiety in general. She noted she works with social anxiety patients and then proceeded to ask questions about th therapy series which showed me she had not looked at the series at all. She did not understand the difference between the book of handouts and the audio therapy. You might say these are innocent questions. Okay, sure. And I answered those questions. I was still surprised that the person had looked at the book of handouts and didn’t know how to apply or use them in a structured way.

To answer your question - if you find a therapist, why not insist on that therapist helping you get through THIS therapy series. Perhaps that will also help you find a therapist who is good for you, someone who is open to helping you in the way that you are currently working on, a way which you know to be a good one. I don’t see a reason to make this more work by doing 2 programs at once, whatever that would mean.


#3

Thank you for your response Mateo. I think this is a great program from what I’ve seen thus far. The way Dr. Richards talks about the disorder is more accurate than I’ve ever heard another human being articulate it.

That’s why I don’t want to give up on this program to start another. As you said, it’s unlikely to find someone with a better program for this specific disorder. However, I’m struggling at applying lessons. It’s hard to know how well you’re doing with the therapy in my opinion since in many ways, it’s measurable. For example, how do I know if I’m really catching all my ANTs? How do I even catch an ANT? I know it’s discussed in the therapy, but I’m having a real hard time with stuff like that.

So the idea of having a face-to-face therapist who I could ask questions to and who could monitor my progress is appealing. But like I said, I don’t want to stop with this program. And I don’t want to go to a therapist for normal talk therapy, since CBT is mainly what I’m interested in and what I think will help me.

If I’m willing to put in the work, do you think it would be a good or bad thing to do two separate CBTs at once (this program and also one with an in-person therapist)? I’m just looking for the best ways to transform my life like everyone else, and am curious if you’ve ever heard of anyone trying something like this before.


#4

I have not heard of someone doing the audio therapy series with a therapist while also doing another program from that therapist. Maybe that happens. I’ve just not heard of that. And, people would not exactly email me to tell me such things, so the fact that I haven’t heard of that is not so significant.

Along the same lines, I can’t really recall anyone telling me for sure that they use Dr. Richards’ series with another therapist. I’ve had the question many, many times - “Can I use this series with another therapist?”. Sure! But then no one emails back later to tell me they are indeed doing that. So that fact again is not very significant.

For you, though, first I would say why not see if a potential therapist would help you through this series? Meet therapists, interview them in a way. Ask them about social anxiety, ask them what they do, do they use CBT? Would they be willing to coach you along through THIS series? Try that first.

If the therapist insists on their own way, you’ll have to make your own decision about that. Do you think the therapist is open to discussion? Do you think the therapy they have you doing is in line with the series? Should be at least the same underlying principles, right? At worst they will probably give you little exercises to do that don’t help much. Or maybe, better, those little exercises will reinforce CBT and be helpful. I don’t imagine them giving you so much work that it will overwhelm you. Again you are the client. If you want to focus your meetings on your questions and YOUR therapy, you should.

A word of caution: some therapists may push people, immersion therapy or flooding. The old “just do it!” approach. You may benefit from some external motivation, but don’t get caught up in some idea of failing by the standards of a therapist who doesn’t understand. We all know “just do it” doesn’t work. You have to do it in the right way and on the basis of using the cognitive therapy. If you get to the point where you can “just do it” while maintaining rational thoughts and feelings, then okay - that motivation will be helpful.

In the end, if you can meet with someone who talks to you about therapy, who helps you work through your questions, who keeps your rational, as a sounding board, then I think that’s great.

Some of the things you wrote: How do I know if I’m really catching all my ANTs? You can’t catch all your ANTs. That’s crazy impossible. That’s not human. ANTs are part of thinking processes anyway. You’ll have doubts and fears your whole life. But we are not talking about doubts and fears that all people have. We’re talking about crazy irrational anxiety ANTs that destroy our lives. And you can’t go from living a life of constant ANTs to catching them all, and you never will. The process is identifying that this does happen and you start to change that. The therapy will work in totality, all ways to get at the problem. Certainly ANT stoppage is one step. And at this point, being aware and catching even 1 ANT is a success.

How do I even catch an ANT? You already know the answer to this. You’re over-thinking the therapy. Don’t be perfect about this. Just apply the therapy as you know what’s right. Be rational with yourself. Be open that many of your previously held thoughts and beliefs might not be so rational. Look at it from that perspective and when you think it is an ANT, then you say that out loud. Tell yourself you don’t choose to think that way. You don’t need to believe that. You want to stop that. You find a distraction, you apply the therapy, you get to the point later where you are turning the tables on the ANTs. Dont’ waste time wondering if you are doing these things perfectly. Keep it simple.

Take care!