From the Guidelines
Cognitive Behavioral Therapy (CBT) is a highly effective treatment for mental health conditions, and it should be offered to patients with anxiety disorders, as recommended by the American Academy of Child and Adolescent Psychiatry 1. CBT works by teaching patients to recognize distorted thinking, develop problem-solving skills, and build confidence in their abilities. The therapy typically involves weekly sessions lasting 45-60 minutes over 12-20 weeks, though duration varies based on condition severity and individual progress.
Key Components of CBT
- Education about anxiety
- Behavioral goal setting with contingent rewards
- Self-monitoring for connections between worries/fears, thoughts, and behaviors
- Relaxation techniques including deep breathing, progressive muscle relaxation, and guided imagery
- Cognitive restructuring that challenges distortions such as catastrophizing, over-generalization, negative prediction, and all-or-nothing thinking
- Graduated exposure incorporating graded tasks to help patients overcome avoidance behaviors 1.
Delivery of CBT
CBT can be delivered individually, in groups, or even through digital platforms, making it accessible to many people seeking mental health support. However, individual therapy is prioritized due to its superiority in terms of clinical- and health-related economic effectiveness 1.
Treatment Outcomes
Many patients see improvement within 8-12 weeks, though some conditions may require longer treatment. The effectiveness of CBT stems from its focus on current problems rather than past issues, its structured approach with clear goals, and its emphasis on developing practical skills that clients can continue using after therapy ends.
Recommendation
CBT should be considered as a first-line treatment for anxiety disorders, including social anxiety disorder, as it has been shown to be effective in reducing symptoms and improving quality of life 1.
From the Research
What is Cognitive Behavioral Therapy (CBT)
- Cognitive Behavioral Therapy (CBT) is a first-line treatment for most mental disorders, including anxiety disorders, depression, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and eating disorders 2, 3.
- CBT is a family of techniques designed to target maladaptive thoughts and behaviors that maintain anxiety over time 3.
- It refers to a type of psychotherapy that focuses on changing negative thought patterns and behaviors to improve mental health outcomes 4, 5.
Effectiveness of CBT in Treating Mental Health Conditions
- CBT has been shown to be effective in treating a range of mental health conditions, including major depression, anxiety disorders, PTSD, OCD, and eating disorders 2, 4.
- The effectiveness of CBT can depend on the type of control condition used, with larger effect sizes observed in waitlist-controlled trials and more modest effect sizes in trials using care as usual 2.
- CBT has been found to be moderately efficacious in reducing symptoms of anxiety disorders, with large effect sizes observed for OCD, generalized anxiety disorder, and acute stress disorder 4.
- CBT has also been found to be effective in reducing symptoms of PTSD, with comparable efficacy to exposure therapy and cognitive therapy 5.
Comparison of CBT to Other Therapies
- CBT has been compared to other therapies, including eye movement desensitization and reprocessing (EMDR), supportive therapies, and cognitive therapy 6, 5.
- While some studies have found that EMDR may be more effective than CBT in reducing symptoms of depression and anxiety in certain populations, other studies have found that CBT and EMDR are equally effective in reducing symptoms of PTSD 6.
- CBT has been found to be more effective than supportive therapies in treating PTSD, but comparable to exposure therapy and cognitive therapy in terms of efficacy and compliance 5.