While group therapy sessions are an important part of treatment and recovery, they can be hugely intimidating – and counterproductive – for people with social anxiety. However there are some simple changes services can make to ensure this client group isn’t left behind, says Vanesa Partlová.
Peer support groups and therapeutic workshops are widely recognised as valuable tools in helping people recover from substance use issues. These group settings offer shared understanding, mutual encouragement, and a sense of belonging – key ingredients for many on the path to recovery. However, not everyone feels empowered or comfortable in these environments.
For individuals who also live with social anxiety, group sessions can trigger overwhelming stress and fear, making participation extremely difficult. This article examines how social anxiety – especially the fear of opening up in front of others – can limit the effectiveness of group treatment for people recovering from substance use disorders.
COPING MECHANISM
Social anxiety involves intense discomfort or fear when interacting with others, particularly in situations where one may be judged or scrutinised. It often leads people to avoid conversations, public speaking, or even small group settings, and many people who live with this kind of anxiety may turn to drugs or alcohol in an attempt to cope with their discomfort in social situations.
Over time, this coping mechanism can develop into a substance use disorder. When these individuals finally seek help, they often encounter group-based treatment models that place them back into anxiety-provoking settings. Although these groups are meant to foster healing and support, the format can unintentionally recreate the very situations that contributed to their addiction in the first place.
Sharing personal experiences is a major component of group recovery programmes. For many, talking about struggles with addiction and the journey toward recovery can be cathartic. But for people with social anxiety, being expected to speak openly in a room full of strangers is extremely intimidating.
The fear of being judged harshly, misunderstood, or viewed as weak often prevents participants from contributing. In tight-knit communities, some people may recognise each other in the group, which adds another layer of anxiety – even with confidentiality rules in place, people may still worry that their story could become public knowledge, threatening their privacy or reputation.
People with social anxiety will therefore often stay silent, share only vague details, or avoid group sessions altogether, meaning they miss out on the very support that could help them move forward in their recovery. Attending a group session is rarely simple for someone with social anxiety – in the hours or days leading up to a meeting, they may feel dread, overthink what they might say, or imagine worst-case scenarios. These thoughts can lead to physical symptoms such as dizziness, rapid heartbeat, sweating, or nausea – making even passive attendance difficult.
SOURCES OF STRESS
Group therapy and peer support programmes are valuable components of addiction treatment, but they are not universally effective. For individuals who live with social anxiety, these spaces can be sources of deep stress, not healing. The pressure to speak up, reveal personal struggles, and interact socially may do more harm than good – causing people to disengage or abandon treatment altogether.
By acknowledging the challenges that social anxiety creates and adjusting treatment programmes to meet people where they are, providers can help ensure that no one is left behind in recovery. Recovery should be about growth, not fear – and that starts with creating spaces where every participant feels safe, heard, and respected.
Vanesa Partlová has an MSc in investigative forensic psychology and is a recovery worker at WithYou