From Anxiety to Confidence: Addressing Emotional Barriers to Social Engagement

PEERS provides a structured pathway for young people with social anxiety to gradually build confidence through supported exposure, addressing the emotional barriers that often undermine social skill development.

Social anxiety represents one of the most common co-occurring conditions for neurodivergent young people with social communication difficulties, creating a challenging cycle where anxiety inhibits social practice while social difficulties intensify anxiety. PEERS addresses this complex relationship by creating a predictable, graduated approach to social engagement that functions as a form of supported exposure therapy. Unlike traditional social skills interventions that may inadequately address the emotional component of social challenges, PEERS integrates cognitive-behavioral strategies—identifying unhelpful thinking patterns, developing coping statements, and building tolerance for social discomfort—alongside concrete skill development.

The program's structure intentionally mitigates anxiety triggers through several key components: breaking complex social situations into manageable steps, providing clear rules that reduce uncertainty, demonstrating successful interactions before expecting performance, and creating a supportive peer environment where mistakes become learning opportunities rather than sources of shame. This graduated approach allows participants to experience the emotional regulation benefits of successful social exchanges—the positive reinforcement that comes from a conversation where they felt competent instead of confused—which research shows can progressively reduce social anxiety symptoms more effectively than cognitive interventions alone.

For referring professionals from CAMHS services, this integrated approach to anxiety and social skills represents a particular strength of the PEERS program. Many young people initially referred for anxiety treatment present with underlying social communication challenges that perpetuate their anxiety, creating a treatment dilemma where standard anxiety protocols yield limited benefits without addressing the social skill deficits. PEERS bridges this gap by simultaneously building social competence and emotional resilience, with research consistently showing significant reductions in social anxiety alongside improvements in social skills—suggesting these outcomes are mutually reinforcing rather than sequential.