The study aimed to reveal the professional performance anxiety levels of nursing students in the preclinical period and to demonstrate the use and change anxiety levels after their exposure to Cognitive Behavioral Therapy processes. Performance anxiety is defined as strong fears that occur only in certain situations and in response to a stimulus, seriously jeopardizing an individual’s capacity to perform a task. This action research study design was conducted with nursing students with high professional performance anxiety levels before clinical practice. This study was a single-group pre-test-post-test pilot study with a 3-month follow-up. Individual observation, interviews, and document or text content analysis were employed as qualitative data collection methods, and the Liebowitz Social Anxiety Scale (LSAS) and Anxiety Symptoms Checklist served as quantitative data collection tools. The population of the study consisted of first-year nursing students ( n  = 140) enrolled in the fall semester of the academic year. The intervention group students ( n  = 9) were selected using criterion sampling, a purposive sampling method. The mean age of the intervention group was 18.78 ± 0.83 years. The LSAS scores significantly decreased from the pre-test to the post-test and then to the follow-up test (χ ²  = 16.22, p   <  0.05). The study found that nursing students had high levels of professional performance anxiety and that cognitive behavioral psychotherapy intervention was associated with reductions in self-reported social anxiety symptoms. The low number of participants in the study and the lack of a control group were important limitations.