# Does Cognitive Behavior Therapy Change Socially Anxious Adolescents’ Behavior during a Public Speaking Task?

**Authors:** Sara L. M. Velthuizen, Esther van den Bos, Anne C. Miers, Jiemiao Chen, P. Michiel Westenberg

PMC · DOI: 10.1007/s10802-025-01420-z · Research on Child and Adolescent Psychopathology · 2026-01-26

## TL;DR

This study explores how cognitive behavior therapy affects the public speaking behavior of socially anxious adolescents, finding improvements in eye contact but not speech disruptions.

## Contribution

The study provides preliminary evidence that cognitive behavior therapy may improve gaze behavior in socially anxious adolescents during public speaking.

## Key findings

- Adolescents showed increased gaze toward audience faces after therapy.
- Older participants exhibited greater improvement in gaze behavior.
- No significant changes in speech disruptions were observed at the group level.

## Abstract

Public speaking is one of the most commonly feared situations by socially anxious adolescents, often prompting behavioral anxiety markers including gaze avoidance and speech disruptions. While the potential adverse social consequences of behavioral anxiety markers in public speaking contexts have been established, research into how these markers might alter through cognitive behavior therapy is still in its infancy. In this preliminary study, we investigated changes in gaze behavior and speech disruptions from before to after 12 weeks of disorder-specific group cognitive behavior therapy among 41 adolescents aged 11–17 years (M = 14.46, 48.78% girls) with social anxiety disorder. Participants spoke for five minutes in front of a pre-recorded classroom audience while wearing an eye-tracker, before and after the Skills for Academic and Social Success program. Following treatment, we found an increase in frequency of gaze towards the faces of the audience while speaking, with greater changes among older participants. There were no changes in speech disruptions at the group level. We conclude that therapy may have a positive effect on gaze behavior, and discuss the clinical implications and opportunities for future research in this emerging field of study.

## Linked entities

- **Diseases:** social anxiety disorder (MONDO:0001247)

## Full-text entities

- **Diseases:** suffering (MESH:D010146), Anxiety (MESH:D001007), eye-gaze (MESH:D015835), disorder (MESH:D009358), SASS (MESH:D019957), anxiety disorder (MESH:D001008), phobias (MESH:D010698), autism spectrum disorder (MESH:D000067877), SAD (MESH:D000072861), Socially anxious (OMIM:300082), behavioral difficulties (MESH:D001523), speech (MESH:D013064), Cognitive distortions (MESH:D006311)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

14 references — full list in the complete paper: https://tomesphere.com/paper/PMC12832577/full.md

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Source: https://tomesphere.com/paper/PMC12832577