Understanding the SUDs Scale for Social Anxiety Assessment

Arlin Cuncic, MA, is the author of The Anxiety Workbook and the founder of About Social Anxiety. She holds a Master’s degree in clinical psychology.

The SUDs Scale, officially known as the Subjective Units of Distress Scale, is a practical method to quantify the level of distress or nervousness experienced by individuals dealing with social anxiety. This self-rating system ranges from 0 to 100, providing a straightforward way to gauge emotional intensity.

Therapists and healthcare professionals frequently utilize the SUDs as a subjective measurement to monitor patient progress and treatment effectiveness. Regular assessments help identify specific areas of distress that may need targeted intervention, making it a valuable component throughout therapy.

SUDs Evaluation Methodology

In cognitive-behavioral therapy, the SUDs scale serves as a simple yet powerful tool to assess current emotional states. Patients are guided to rate their anxiety based on how they feel in the moment, considering physical sensations like tension or tightness in the body.

Here is a simplified version of the scale with key reference points:

Assessing Your Anxiety Level

• 100: Overwhelmed with distress, unable to function, possibly nearing a breakdown
• 90: Extremely anxious, feeling desperate and helpless
• 80: Panic and worry dominate; focus is lost; physical anxiety present
• 70: Discomfort interferes with normal functioning
• 60: Noticeable discomfort with moderate to strong feelings
• 50: Uncomfortable but still able to function
• 40: Mild to moderate anxiety and concern
• 30: Slight worry or upset, functioning remains possible
• 20: Mild sadness or distress
• 10: No significant distress; alert and attentive
• 0: Complete calm and tranquility

It’s important to note that precise measurement isn’t the goal; rather, the SUDs provides a broad overview to help your therapist understand your current emotional state.

The Six Core Emotions

Expressing the intensity of your feelings can be challenging. The SUDs scale offers a simple way to communicate how strongly you are experiencing emotions. Sharing your ratings with your therapist is crucial, as it reflects your personal experience rather than external interpretations of your fear or anxiety.

People with social anxiety often feel emotions and fears more intensely than others. What might seem minor to someone else can feel overwhelming to you. This perspective influences how you see yourself and others, and discussing your SUDs ratings helps clinicians better understand your unique experience.

Practical Steps for Managing SAD

SUDs in Therapy: Tracking Progress

Using the SUDs scale regularly can help you and your therapist identify patterns of improvement or setbacks. Honest ratings are essential for effective treatment adjustments and understanding which strategies work best for you.

Recognizing intense distress in response to seemingly minor triggers can highlight areas needing focused work. Based on your assessments, your therapist may introduce techniques such as cognitive disputation, which involves challenging irrational thoughts and replacing them with more balanced perspectives.

Applying these cognitive strategies in daily life can gradually improve your SUDs scores, leading to reduced anxiety over time.

Understanding Disputation

A Word from Verywell

Honest completion of the SUDs scale is vital for its usefulness. Avoid responding in a way you think your therapist expects; instead, rate your feelings based on your current state, regardless of whether you perceive it as good or bad.

Research indicates that children and teens may sometimes miscommunicate their emotional states when using the SUDs, so if you or your child fall into this age group, inform your therapist or doctor about any concerns regarding the tool’s application.

Additional Resources on CBT and Anxiety Management

• Conditions A-Z
• Anxiety
• Social Anxiety Disorder
• Treatment and Therapy

At Verywell Mind, we rely solely on high-quality, peer-reviewed sources to ensure accurate and trustworthy information. Learn more about our editorial standards and fact-checking process.

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2. Tanner BA. Validity of Global Physical and Emotional SUDS. Applied Psychophysiology and Biofeedback. 2012;37(1):31-34. doi:10.1007/s10484-011-9174-x

3. Farmer AS, Kashdan TB. Stress sensitivity and generation in social anxiety disorder: A temporal analysis. Journal of Abnormal Psychology. 2015;124(1):102-114. doi:10.1037/abn0000036

4. Clément C, Lin J, Stangier U. Effectiveness of behavioral experiments in CBT for social anxiety: A study protocol. Trials. 2019;20(1):748. doi:10.1186/s13063-019-3905-3

5. Kiyimba N, O’Reilly M. Use of SUDs in child mental health assessments: A thematic review. Journal of Mental Health. 2020;29(4):418-423. doi:10.1080/09638237.2017.1340616

Authored by Arlin Cuncic, MA, an expert in anxiety management and founder of About Social Anxiety. She holds a Master’s degree in clinical psychology.

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