From the Guidelines
Cognitive Behavioral Therapy (CBT) is a diverse group of interventions targeted at the three primary dimensions of anxiety: cognitive, behavioral, and physiologic, aiming to eliminate emotional and physical distress, change maladaptive beliefs and attitudes, and alleviate avoidance behavior. According to the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders published in the Journal of the American Academy of Child and Adolescent Psychiatry in 2020 1, CBT typically involves a structured approach with homework assignments, collaboration among the patient, family, and therapist, and is characterized by a goal-oriented agenda. The primary elements of CBT for anxiety disorders include:
- Education about anxiety
- Behavioral goal setting with contingent rewards
- Self-monitoring for connections between worries/fears, thoughts, and behaviors
- Relaxation techniques such as 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 techniques. The goal of CBT is to achieve meaningful symptomatic and functional improvement within 12 to 20 sessions, with systematic assessment of treatment effectiveness using standardized symptom rating scales to optimize therapists’ ability to accurately assess treatment response and remission 1.
From the Research
Definition of Cognitive Behavioral Therapy (CBT)
- Cognitive Behavioral Therapy (CBT) is a therapeutic approach that has been applied to a variety of problems, including anxiety disorders, substance use disorder, schizophrenia, and other psychotic disorders 2.
- CBT is based on the cognitive behavioral model, which conceptualizes anxiety as caused by a pattern of maladaptive cognitive appraisals and avoidance behaviors that perpetuate pathologic fears 3.
- The goal of CBT is to target maladaptive thoughts and behaviors that maintain anxiety over time, and to help individuals eliminate avoidant and safety-seeking behaviors that prevent self-correction of faulty beliefs 4, 5.
Core Components of CBT
- CBT includes core components such as psychoeducation, cognitive restructuring, exposure therapy, and relapse prevention 3.
- These components are relevant across anxiety disorders and are designed to help individuals manage their anxiety and reduce stress-related disorders 4.
- CBT protocols have been developed for individual presentations of anxiety, including panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and prolonged grief 4.
Efficacy of CBT
- CBT has a strong evidence base supporting its short-term and long-term efficacy and effectiveness in treating anxiety disorders 3, 6.
- Meta-analytic studies have shown that CBT is effective in treating a variety of mental health problems, including anxiety disorders, depression, and substance use disorder 2.
- CBT has also been shown to be effective in managing physical conditions such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome 5.