What to Expect From Cognitive Behavioral Therapy for Anxiety

CBT can help relieve symptoms of anxiety

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Cognitive behavioral therapy (CBT) is a type of psychotherapy commonly used to treat anxiety disorders, like generalized anxiety disorder (GAD), mood disorders, and eating disorders.

CBT is a present- and problem-focused, structured talk therapy that focuses on conscious thoughts as opposed to subconscious ones. It is generally a short-term treatment but can be longer if your symptoms tend to wax and wane over time.

One of the overarching goals of CBT is to help you gradually become your own therapist.

If you have GAD, CBT can significantly improve your symptoms, even after treatment ends. CBT may also reduce the need for medications

Working With a Cognitive Behavioral Therapist

CBT is typically offered by clinicians who are trained in psychotherapy. CBT therapists tend to be quite active during the session. Their style is likely to vary between educational, conversational, and reflective.

A CBT therapist could be a psychiatrist, psychologist, social worker, or mental health counselor. If you are interested in trying CBT, ask the clinician you are seeing about their training background or seek out an experienced CBT practitioner through referral sources such as The Association for Behavioral and Cognitive Therapies or The Anxiety and Depression Association of America.

CBT sessions typically are scheduled for once per week.

If your symptoms are significantly impairing your day-to-day functioning or you are new to therapy, your clinician may want to see you twice a week for a few weeks. After several months of weekly sessions, if you and your therapist agree that your symptoms are improving, you might arrange to meet less frequently―perhaps twice per month.

As you approach the end of treatment, you may meet even less frequently―once a month or once every other month to make sure you are adequately managing any recurrent symptoms or setbacks.

Even after your formal treatment period has ended, you may find it helpful to return to your therapist for booster sessions on occasion. These meetings serve as a check-in and a refresher on particularly helpful skills for you.

Main Components of CBT

CBT interventions include education about anxiety, understanding more about your anxiety by self-monitoring, learning to relax, controlling thoughts that cause anxiety using a variety of cognitive therapy approaches, facing fears, and problem-solving issues for which anxiety might be expected and proportionate.

In general, these techniques reflect several important areas in need of change:

CBT sessions are fairly structured. The agenda for the meeting will be agreed upon by you and your therapist at the start of the appointment. This collaborative style extends throughout the session, as you work together with your therapist to cover as much of the agenda as feasible.

After establishing a plan for your meeting, homework is reviewed. CBT therapists often give homework. This could be reading related to an important therapeutic topic or it could be a written or behavioral assignment to track aspects of your anxiety and help practice new ways of thinking or acting.

Following homework review, new or ongoing topics are addressed. These may build off of the homework, relate to what has occurred in your life since your last meeting, or cover other issues deemed important by you and your clinician. At the conclusion of the session, a new assignment―work for you to do between sessions to get the most out of your treatment―will be agreed upon.

Sources

Craske MG, Barlow, DH. Mastery of Your Anxiety and Worry Workbook (2nd Edition). In DH Barlow (Ed.) Treatments That Work. New York: Oxford University Press.

Newman MG, Crits-Christoph PF, Szkodny LE. Generalized Anxiety Disorder. In L Castonguay & T Oltmanns (Eds.), Psychopathology: From Science to Clinical Practice. New York: Guilford Press, 2013, p. 62-87.

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