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CBT for Anxiety

Cognitive Behavioural Therapy is the most popular form of therapy for a range of issues that fall under the umbrella term 'anxiety', using a solution-focused, 'here and now' approach to facilitate recovery. We take a look at what this means and at the evidence in its favour.

Cognitive Behavioural Therapy for Anxiety

Studies indicate that anxiety is the most common form of psychological problem; almost a third of us will experience anxiety at a clinically significant level at some point in our lives, and many of us will seek therapy to help get through it.

‘Anxiety’ in psychology and psychiatry is an umbrella term covering a range of distinct problems, all of which have in common a general experience of anxiety (worry, nervousness or unease), physical tension and avoidance.

Most often when we speak of anxiety in psychological settings, what is meant is ‘generalized anxiety disorder’–a long-lasting anxiety that is not focused on any particular object or situation. But other forms of anxiety include: panic (commonly accompanied by agoraphobia), social anxiety, phobias, OCD obsessive compulsive disorder, and PSTD post-traumatic stress disorder.

What we think and what we do are deeply connected

The most popular psychotherapy used in the battle against anxiety is CBT Cognitive Behavioural Therapy. As the name suggests, this type of therapy is based on the premise that emotional problems are maintained by our styles of thinking, and that we can instigate positive changes in these factors through cognitive (e.g. cognitive restructuring) and behavioural (e.g. exposure, behavioural experiments, relaxation training) techniques.

Anxiety can involve a wide range of symptoms

In undertaking them, these techniques help us to develop more adaptive and healthy cognitions and behaviours with a recognition that what we think and what we do are deeply connected. CBT can be tailored to each person’s needs at a number of levels of intensity, making it useful whether you’ve only just started feeling mildly anxious, or if you have been battling anxiety for a long time.

CBT is very much a present-tense, solution focused therapy: the emphasis is on the ‘here and now’, rather than trying to pinpoint causes of problems in our history: we cannot change our past, but we can change how we think and behave in the present, and only this has the power to positively shape our future.

The effectiveness of CBT for anxiety

The body of evidence for CBT for anxiety is vast: hundreds of studies exist, which is great, but can be daunting when trying to draw a reliable conclusion as to whether CBT actually aids recovery! Dr Christian Otte from the Charite University Medical Center in Berlin last year set about tackling this problem by undertaking a systematic review of the hundreds of meta analyses (statistical contrasts and comparisons of the results of a large number of studies) that exist in this area.

He was interested in not just the efficacy (how well something works in controlled settings like a clinical trial) but also the effectiveness (how well something works in the real world) of CBT for anxiety: it’s all well and good if a therapy works during a psychological study, but what really matters is that it works in the everyday therapeutic environment!

After looking at dozens of meta analyses encompassing hundreds of trials, Dr Otte was able to conclude that CBT demonstrates both efficacy and effectiveness in the treatment of the full range of anxiety problems (Generalized Anxiety Disorder, social anxiety, panic, OCD and PTSD), which supports the National Institute for Health and Clinical Excellence’s (NICE) recommendation that CBT be the treatment of choice in the UK.

The House Partnership, 22nd April 2015

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