As the field of psychology is ever evolving, more and more therapeutic approaches are emerging. Cognitive behavioral therapy is one type of psychological treatment and therapy approach that originated in the 1960s and is still widely used today. Given how effective it can be, the Atlanta psychologists at Best Within You Therapy & Wellness all integrate Cognitive Behavioral therapy into their approaches. Seen as one of the most effective forms of treatment, let’s break down what cognitive behavioral therapy is and how it helps with anxiety.
What is cognitive-behavioral therapy?
Cognitive behavioral therapy is a treatment method that is effective for a range of mental health issues such as anxiety, depression, eating disorders, and more (APA, 2022). The core principle of cognitive behavioral therapy is that thoughts create feelings which create behaviors which then reinforce the original thoughts (Gelso, 2014). As such, the basic premise is that by targeting maladaptive or unhelpful thoughts, unwanted behaviors can be reduced or eliminated. Cognitive behavioral therapy assumes that behaviors are learned and therefore can be unlearned through therapeutic treatment strategies (Gelso, 2014).
Usually in cognitive behavioral therapy, the therapist takes a more directive role with their clients while also aiming to establish a good therapeutic relationship (Gelso, 2014). The client and the therapist establish specific, measurable and actionable goals early on, focusing on targeting unwanted thoughts and behaviors. Cognitive behavioral therapy is often a briefer therapy with a focus on presenting symptoms rather than on past history (Gelso, 2014). Due to this feature, cognitive behavioral therapists will often assign homework for their clients to complete outside of sessions to reinforce or practice the new thoughts and behaviors.
While we are a fan of cognitive behavioral therapy and many of our Atlanta therapists practice cognitive behavioral therapy, we want to provide you with information about strengths and weaknesses of this approach. A weakness of cognitive behavioral therapy is that if you only address presenting symptoms rather than the root cause, the underlying issue that the client is facing may not be resolved (Gelso, 2014). However, this can be lessened by taking a cognitive behavioral approach to reduce presenting symptoms and then investigating underlying issues through a more integrative and dynamic lens. Our Atlanta therapists tend to not follow a step by step cognitive behavioral manual with clients. We recognize each person is unique and always tailor treatment.
A major strength is that cognitive behavioral therapy is short-term and measurable, meaning that clients are able to see change in a brief period of time (Gelso, 2014). This is especially important for clients with severe presenting problems. Another strength is that it is heavily research supported with many studies showing the effectiveness of this therapy approach.
Cognitive behavioral therapy for anxiety: how does it help?
Cognitive behavioral therapy is one of the most effective forms of therapy for treating anxiety disorders. A 2009 meta-analysis showed that cognitive behavioral therapy is an effective treatment for anxiety disorders in as little as 8 sessions, regardless of whether the client took medication or not (Stewart & Chambless, 2009). Let’s discuss some of the most widely used treatment methods for anxiety disorders from a cognitive behavioral approach.
One common treatment for anxiety is systematic desensitization (Gelso, 2014). The basic premise of desensitization is to pair gradually more and more anxiety-provoking events with effective relaxation techniques to eventually eliminate anxiety. First, the client is asked to construct a fear hierarchy. For example, a client that has social anxiety may have a fear hierarchy that looks like this:
|Situation||Fear Ranking (1-10)|
|Walk around a crowded mall||3|
|Start a conversation with a stranger||5|
|Go to a party||7|
|Ask someone out on a date||8|
|Give a speech in front of 100 people||10|
Then, the therapist teaches the client various relaxation techniques such as deep breathing, progressive muscle relaxation, meditation, or mindfulness exercises. To learn more about these relaxation techniques and how to practice them, check out our finals tips blog post. Once the client has learned these techniques, the therapist will guide them through their fear hierarchy in order to pair relaxation techniques with increasingly more anxiety inducing situations. Over time, the goal is that the client will be able to effectively use these relaxation techniques on their own even in the most anxious situations.
Another highly effective treatment for anxiety is exposure. The aim of exposure is to repeatedly place the client in high-anxiety situations. When the client experiences no harm in these situations, their anxiety is reduced and eventually eliminated over time (Gelso, 2014). For example, let’s say a client is anxious about being around a large group of people. The therapist and the client could go to a crowded mall, restaurant, or street over the course of their sessions. Over time, the goal is that the client will see that no harm occurred from being among large crowds and will feel comfortable in these situations on their own.
Participant modeling is also a treatment method commonly used for treating fears and anxieties (Gelso, 2014). This technique requires the therapist to model desired behaviors, followed by the client imitating these responses. Participant modeling is conducted in a gradual fashion within sessions and may be less daunting than some of the other treatment techniques. Participant modeling rests on the assumption that behavior is learned through observation. For example, if a client is afraid of spiders and sees the therapist panic and scream when they see a spider, the client’s response to spiders will likely be similar. However, if the client sees the therapist react in a calm manner, the goal is that they will mimic this modeled behavior.
Modeling and role playing are also used to help clients gain more confidence in situations. For example, a therapist may model what to say to a friend that upset the client or a boss when they are wanting a promotion. The therapist and client may also role play a feared situation in session to help the client gain confidence in facing this situation.
A thought record is another common technique used in therapy. With a thought record, a client will be able to recognize patterns of unhelpful thinking. They then are able to evaluate the evidence of their thoughts and how these thoughts impact feelings. Self statements are used that clients can repeat to themselves instead of saying the initial anxiety provoking statement.
It is important to note that with all cognitive behavioral therapy treatments, the client is very much in control. If the client does not feel comfortable with any particular treatment approach or speed of treatment, the therapist will listen and fit the treatment around their needs.
Cognitive Behavioral Therapy Takeaway
In summary, cognitive behavioral therapy is a widely researched and accepted form of treatment for a range of issues from anxiety to phobias to depression and eating disorders. Cognitive behavioral therapy for anxiety can help you achieve tangible results. With a range of treatment options available, cognitive behavioral therapy can be molded to fit your needs and comfort level in order to reduce your presenting symptoms. If you are looking for therapy for anxiety and feel like you could benefit from cognitive behavioral therapy, do not hesitate to schedule a free consultation with one of our Atlanta Georgia licensed psychologists. You can also learn more here about our anxiety therapy approaches here.
– Than you Rumi Petrovia, Best Within You Therapy & Wellness Intern