SUDs Rating Scale for Measuring Social Anxiety

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The SUDs Rating Scale, or Subjective Units of Distress Scale (SUDs) as it is officially known, is used to measure the intensity of distress or nervousness in people with social anxiety. The SUDs is a self-assessment tool rated on a scale from 0 to 100.

The SUDs is a subjective tool often used by therapists and healthcare providers to evaluate patient progress and the success of treatment plans. When used this way, it is used regularly throughout treatment to gauge different areas of distress or disturbance that require additional work.

SUDs Rating Process

A common technique in cognitive therapy is using the SUDs tool to gauge distress or emotional state. Guidelines for the SUDs include rating the intensity of your anxiety as it is experienced in the moment verus while tightening or tensing of the body.

Below is a simplified version of the scale with different guide points:

Rating Your Distress

  • 100: Unbearably upset to the point that you cannot function and may be on the verge of a breakdown
  • 90: Extremely anxious and desperate; helpless and unable to handle it
  • 80: Worried and panicky; losing focus and feeling anxious in your body
  • 70: Discomfort dominates your thoughts and you struggle to function normally
  • 60: Moderate to strong levels of discomfort
  • 50: Upset and uncomfortable; still functional
  • 40: Mild to moderate anxiety and worry
  • 30: Worried or upset; still able to function
  • 20: A little bit sad or distressed
  • 10: No distress; alert and focused
  • 0: Peaceful and complete calm

Precise accuracy of measurement is not important. Rather, the SUDs is a broad guide to give your therapist an idea of what you are experiencing.

For many, it can be difficult to share the intensity of what you are feeling. In this way, the SUDs give you a simple way to express the severity of your emotions. It is especially important to share your SUDs scale rating with your therapist because it reflects how you feel, rather than how someone else interprets your fear or anxiety.

It is common for those with social anxiety to feel emotions and fears more intensely than others. What could be a minor incident to someone else can feel like a catastrophe to you. Social anxiety influences your perspective and how you view yourself and those around you. Sharing how you feel based on the SUDs can help therapists and healthcare providers better understand how social anxiety may be affecting you.

SUDs and Therapy

Use of the SUDs can help you and your therapist track improvements or setbacks in treatment. Be sure to complete the scale honestly to allow your therapist to appropriately judge which treatment methods are working and which are not.

Through the SUDs scale, you may realize you feel intensely distressed by something that typically wouldn't bother others. This is a good indicator of an area you need to work on.

Based on your SUDs assessment, your therapist may have you work through techniques such as disputation, during which you recognize irrational thoughts and work to replace them with more rational ways of looking at situations.

This and other cognitive skills are learned in therapy, but continue to develop as you begin to apply them to your daily routine. You may find that working through issues with cognitive strategies improves your SUDs rating.

A Word From Verywell

Rating scales such as the SUDs are only useful if you complete them honestly. Try not to respond in the manner you think your therapist wants, as this can be a trap for those with social anxiety disorder. Instead, give ratings based on how you are feeling in the moment, regardless of whether you think it is good or bad to be feeling that way.

Research on the use of SUDs with children and teens has shown that miscommunication can sometimes be a problem. If you or your child fall into this age range, be sure to tell your therapist or doctor if you are concerned about the use of the SUDs tool.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Arlin Cuncic, MA
Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master's degree in clinical psychology.