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Social Anxiety Telehealth Psychology Sydney: How Therapy Works and What to Look For

Last reviewed: June 2026 • Sources: Bouchard et al. (2022) Journal of Clinical Medicine; Shaker et al. (2023) JMIR; NICE guidelines for social anxiety disorder

Social anxiety is one of the most common presentations that people bring to psychology—and one of the most undertreated, in part because the act of seeking help can itself feel difficult when your anxiety centres on being evaluated, judged, or embarrassed in social situations.

This guide explains what social anxiety disorder is, how psychological treatment works, and how telehealth fits into that picture—including the specific reasons why telehealth can be a good starting point for people with social anxiety, and what the research says about its effectiveness.

What is social anxiety disorder?

Social anxiety disorder (also called social phobia) is characterised by an intense, persistent fear of social or performance situations in which the person believes they may be negatively evaluated, embarrassed, or humiliated. The fear is out of proportion to the actual level of threat the situation poses.

Common situations that trigger social anxiety include:

• Speaking in meetings or in front of groups
• Meeting new people or starting conversations
• Eating or writing in public
• Situations where you may be watched doing something
• Using public transport or being in crowded places when you feel self-conscious
• Making phone calls, especially to people you don't know
• Asserting yourself or disagreeing with others

Social anxiety is not the same as shyness or introversion, though both exist on a continuum. Social anxiety disorder involves significant distress and often leads to avoidance—people restructure their lives to avoid the feared situations, which typically makes the anxiety worse over time by preventing natural anxiety reduction through experience.

How common is social anxiety?

Social anxiety disorder is estimated to affect approximately 7–13% of people at some point in their lifetime, making it one of the most prevalent anxiety disorders. Many people with social anxiety go untreated for years, often because seeking help itself involves the kind of social contact they find difficult, or because they have normalised their anxiety as "just being shy."

How psychological treatment for social anxiety works

Cognitive Behavioural Therapy (CBT)

CBT has the strongest evidence base for social anxiety disorder and is the frontline recommended psychological treatment in Australian and international clinical guidelines.

CBT for social anxiety typically involves two interconnected components:

1. Cognitive restructuring

Social anxiety is maintained by unhelpful patterns of thinking. Common ones include:

• Overestimating threat: "Everyone will notice I am nervous", "I will say something stupid", "They will think I am boring"
• Catastrophising consequences: "If I blush, it will be humiliating and I will never recover from it"
• Post-event processing: Replaying social interactions repeatedly and focusing on what went wrong
• High standards for social performance: Believing you must come across perfectly to be acceptable
• Self-focused attention: Over-monitoring your own behaviour and physical sensations during social interactions

Cognitive restructuring involves identifying these patterns, examining the evidence for and against them, and developing more balanced, realistic ways of thinking about social situations.

2. Behavioural experiments and exposure

Avoidance maintains anxiety because it prevents you from learning that the feared outcomes either do not happen, or are manageable if they do. Exposure involves gradually, systematically approaching feared situations rather than avoiding them.

Exposure is hierarchical—you start with situations that are manageable and work up toward more challenging ones. The exposure work happens between sessions in real-life situations; your psychologist helps you plan it, debrief it, and understand what you learned from it.

CBT also addresses safety behaviours—the things people with social anxiety do to try to prevent feared outcomes or manage anxiety in the moment (like avoiding eye contact, over-preparing, or speaking quietly to avoid standing out). Safety behaviours often maintain anxiety by preventing disconfirmation of feared beliefs.

Acceptance and Commitment Therapy (ACT)

ACT takes a different angle: rather than directly challenging anxious thoughts, it focuses on changing your relationship with those thoughts (defusion), accepting the discomfort of anxiety as part of living a full life, and clarifying your values so you can act toward them even when anxiety is present. Some people with social anxiety find ACT's approach intuitive and well-suited to their situation, particularly if they have already tried CBT without complete success or if their social anxiety is tied to deeper questions about identity and belonging.

How long does treatment take?

Research protocols for CBT for social anxiety typically involve 12 to 16 weekly sessions. In practice, some people respond significantly in fewer sessions; more complex, longstanding, or severe social anxiety may take longer. Under Medicare's Better Access scheme, you can access up to 10 Medicare-rebated psychology sessions per calendar year with a Mental Health Treatment Plan from your GP.

Telehealth and social anxiety: what the research shows

The question of whether telehealth is appropriate for treating social anxiety disorder deserves a direct answer, because it might seem counterintuitive at first: if social anxiety involves fear of social interaction, how can a therapy conducted via video be effective when real-world social encounters are still required?

The research is reassuring. A 2022 randomised controlled trial by Bouchard and colleagues (published in the Journal of Clinical Medicine) found that videoconference-delivered CBT was non-inferior to in-person CBT for anxiety presentations including social anxiety, with equivalent symptom reduction and treatment completion rates. An earlier 2023 systematic review and meta-analysis by Shaker and colleagues (JMIR Mental Health) confirmed that internet-delivered CBT produces clinically meaningful reductions in social anxiety symptoms.

There are good clinical reasons for these findings:

• The cognitive work in CBT (identifying, examining, and challenging beliefs about social evaluation) happens in conversation with your psychologist. This works as well via video as in person.
• The exposure work happens in real-life situations between sessions, regardless of whether sessions are in person or via telehealth. Going to a work function, making a phone call, or speaking up in a meeting are the same challenges whether your psychologist is a video call or an in-person appointment.
• Debriefing and planning exposure exercises can be done effectively in a telehealth session.

Why telehealth often suits people with social anxiety specifically

This is worth acknowledging directly. For some people with social anxiety, the act of attending a new practice for the first time involves several of the very situations they find most difficult: travelling to an unfamiliar place, sitting in a waiting room, meeting a new person who will be evaluating them, and navigating the social formalities of an appointment.

None of that means in-person psychology is worse—for many people it is excellent. But for some, these barriers are significant enough that they delay seeking help for years, or cancel appointments at the last minute, or never book at all.

Attending from home removes those specific barriers. You are in a space you know, there is no waiting room, and the video call itself does not have the social choreography of a physical meeting. That can be enough to make the difference between starting treatment and not starting at all.

One thing to be clear about: starting telehealth is not a strategy for avoiding social situations in general. The treatment still involves facing feared situations. Telehealth reduces the barrier to the therapeutic relationship itself, not to the work.

What to look for in a psychologist for social anxiety

Experience with anxiety presentations

Ask explicitly whether the psychologist has experience treating social anxiety disorder. Social anxiety has specific CBT protocols (for example, Clark and Wells model; Heimberg's group CBT model) and some psychologists are more familiar with these than others. "I work with anxiety" is a reasonable start; "I specifically have experience with social anxiety disorder and use CBT including exposure work" is better.

Familiarity with exposure-based approaches

Effective treatment for social anxiety almost always involves some exposure component. Ask whether the psychologist incorporates exposure exercises into their work. A psychologist who only works cognitively, without behavioural components, may not be working to the most evidence-supported protocol for this presentation.

Comfort with telehealth delivery

Most psychologists now offer telehealth comfortably, but it is worth asking: "Are you comfortable working with social anxiety via telehealth?" and "How do you approach the exposure component when working via video?" These questions give you a sense of the psychologist's experience and approach.

A good fit

For social anxiety treatment specifically, the therapeutic relationship matters. You are working on fears about being evaluated—so you need a psychologist with whom you feel reasonably safe to be honest about your experiences. It is normal to feel some apprehension at the start. However, if after a few sessions you still do not feel able to be open, it is worth considering whether the fit is right.

For more guidance on choosing a psychologist, see our how-to-choose guide.

Access and cost in Sydney

A Mental Health Treatment Plan from your GP gives you access to Medicare rebates on up to 10 individual psychology sessions per calendar year. The rebate is $98.95 per session for a registered psychologist or $145.25 for an endorsed clinical psychologist (from 1 July 2025, Medicare Benefits Schedule).

Private psychology fees in Sydney typically range from $180 to $300 per session. Your out-of-pocket gap after the Medicare rebate is usually $80 to $150. Some psychologists offer concession rates. For full cost information, see our cost guide.

Our directory lists registered psychologists in Sydney who specialise in anxiety (including social anxiety), offer telehealth, and accept Mental Health Treatment Plan referrals. Many list their fees and experience directly on their profile.

Frequently asked questions