**1.3. Exposure**

Exposure technique is one of the best ways to deal with SAD symptoms. In the treatment of SAD, in vivo exposure often has been used. In exposure therapy, the following approaches are involved: psychological education about exposure, development of anxiety hierarchy worksheets, specifying exposure settings, execution of exposure, and anxiety assessment before and after exposure. In psychological education, participants learn in advance the characteristics of anxiety and what will be conducted in exposure therapy. They need to sufficiently understand the nature of psychological burden when implementing the therapy.

**1.5. Video feedback**

underestimation of social skills [23].

**1.6. Mindfulness**

here-and-now [26].

Video feedback (VF) is one of the important and effective techniques in most CBT treatment programs. Individuals with SAD try to watch their video before receiving sufficient cognitive preparation. Clark et al. [18] reported a high impact from individual CBT. This program consisted of developing with patients a personal set of safety behaviors and a self-focused attention experiment: shifting the focus of attention to the social situation. In video feedback sessions, individuals with SAD watch their actual social tasks, which are public speaking and conversation. They often recognize their performance is worse than actual performance. Therapists try to change the discrepancy between subjective and objective perceptions of social performance. VF involves providing individuals with video playback of their social performance following their participation about social task, such as a public speech or a oneon-one conversation [22]. High socially anxious and individuals with SAD watch the real situation through recorded video. Video feedback involves video recording socially anxious individuals while they are trying a social task, that is, a speaking task or conversation. It is anticipated that review of the recording corrects distorted self-evaluations, including the

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Though video feedback sessions are effective, it is necessary to consider that participants might have a resulting psychological burden. Shirotsuki [24] indicated the effects of the interpretation of video images: when watching video images, sometimes, participants cannot perceive themselves objectively owing to their negative interpretation of the video images, which reduces the self-evaluation of their performance. It is considered important to try to

In recent years, researchers and clinicians have developed intervention programs that include mindfulness. Mindfulness is defined as "paying attention in a particular way—on purpose, in the present moment and nonjudgmentally" [25]. Bishop et al. [26] distinguished two components of mindfulness. The first component is "self-regulation of attention." Self-regulation of attention is observing and attending to the changing field of thoughts, feeling, and sensations from moment to moment. This leads to a feeling of being very alert to what is occurring in the

The second component is "orientation to experience." Orientation to experience is an attitude of openness, acceptance, and curiosity about the present moment. Experiential avoidance which is the opposite concept of orientation to experience is at the heart of all psychological distress [27]. It is to avoid one's own experience such as thought, feeling, cognition, behavior, and sense of body. Experiential avoidance is reduced by increasing the mental state of orien-

Many researchers have found relationship between trait mindfulness and mental health criteria. Baer et al. showed that trait mindfulness was negatively correlated with alexithymia, dissociative activities, difficulties in emotion regulation, and neuroticism [29]. Higher levels of trait mindfulness predict lower levels of anxiety, depression, and negative cognition, and

make participants watch video images objectively before the session.

tation to experience; as a result, psychological distress improves [28].

Through developing an anxiety hierarchy worksheet, the situation of anxiety and the degree of anxiety in each situation become clear. Through setting discussion in concrete situations, problems are shared between the therapist and client. The first aim of exposure therapy is to reduce anxiety. Social settings tend to change in the condition where anxiety feelings are high. For example, speech situations usually finish in a few minutes. Participants tend to finish the situation with high anxiety, which leads to avoidance behaviors in the next anxiety situation. It is important to properly expose themselves to each anxiety situation repeatedly. Exposure therapy is often conducted during a treatment session (regardless of inside or outside of the treatment institutions) or in an actual setting as homework. Though imagined exposure is also effective, when exposure in real life can be used, this can be related to daily situations.
