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A formulation based on Clark and Wells' cognitive model of social anxiety — mapping self-focused attention, the observer-perspective self-image, and safety behaviours.
This formulation maps how social anxiety is maintained by a shift in attention inward (self-focused attention), the creation of a distorted self-image, the use of safety behaviours that often cause the feared outcome, and pre- and post-event rumination. Work through it with your therapist using a recent social situation.
Use at the formulation stage with clients presenting with social anxiety disorder. The Clark and Wells model should be the primary framework when the client demonstrates self-focused attention, safety behaviours, anticipatory processing, and post-event rumination as key maintaining factors.
Build the formulation collaboratively using a recent social situation as the anchor example. Start with the situation and the client's appraisal, then map maintaining cycles by asking about what they noticed in their body, what they did to cope, and what went through their mind afterwards.
For clients with multiple feared social situations, develop the formulation using the most representative or distressing situation first, then test whether the same maintaining processes apply across situations. Simplify the diagram for clients who find complex visual models overwhelming.
Not appropriate for social difficulties arising primarily from autism spectrum conditions, where the maintaining processes differ fundamentally. Also reconsider if the primary presentation is better captured by another model (e.g., avoidant personality features requiring schema-level work).
The self-image component is often the most novel and therapeutically powerful element for clients. Many have never considered that they are operating from a distorted internal image of how they appear to others. Eliciting this image vividly is crucial for effective treatment.
Suitable for clients working with social anxiety, formulation, clark, wells, cognitive model, cbt, self-focused attention, safety behaviours. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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Record and reflect on social situations to identify the role of self-focused attention, safety behaviours, and predictions.
Compare your internal self-image with how you actually appear on video to challenge distorted self-perception in social anxiety.
Track changes in a specific social belief across multiple experiments — building cumulative evidence for an updated view of yourself in social situations.
Monitor and challenge the post-mortem rumination that follows social situations — a key maintenance factor in social anxiety.