Lots of people on the social anxiety forum seem to have had very bad experiences with CBT although it only works for 75% anyway. The trouble is that many NHS trusts are advocating using CBT as the only solution to all anxiety and depression cases as they are so short of money and think its the best option. It doesn’t work for some people as all talking to strangers is hard and often does not get any better due to constant failure which as I have said many times only increases anxiety. You have to have success to be able to gain confidence in order to try new things and often trying to make small talk to someone at work or a cashier in the supermarket is strained and awkward so it is painful and embarrassing. This sometimes even results in ridicule. It did for me at work when i was told that I only talk about certain subjects with certain people. Yes, that’s because I never did anything or went anywhere and had no idea what to talk about otherwise so the only other option was complete avoidance. They advise you to try anything as if its always positive but in reality all failure or weird behaviour from us gets ridicule which actually makes our anxiety worse. It obviously needs some kind of way to help people to communicate better and more confidently first before they go into real life situations or they only fail and get worse.This is why other types of therapy are often far more useful before we try social situations but of course everyone is different.
I remember the self help book I got many years ago which advised going into the local shop and talking about the weather. Yet if you do that every day and are awkward or the shop keeper is less than friendly you will soon be known as the mad or strange person that always talks about the weather. if you go and sit alone in the coffee shop and act weird and nervous you will be known by the staff and regulars as the weird nervous guy and even laughed at. if you have chronic paranoia as I have had and thought everyone was mocking me then you get much worse, not better. Without having the confidence which often includes a normal voice, mannerisms and body language which most normal people take for granted the very shy person often gets worse by continually doing and saying the wrong thing and feeling awkward. This is why CBT for me with my lack of motivation, depression and cynicism which are often ignored would be no more useful than telling me to pretend I was a giant chicken and clucking at the shopkeeper although actually hypnotism may be more useful than CBT.