Cognitive behavioral therapy (CBT) is a collection of techniques and strategies proven to assist people with anxiety disorders. According to Cape, Whittington, Buszewicz, Wallace, and Underwood, (2010), when a person is suffering from panic attacks such as an incapacitating phobia, unrelenting worries, or obsessive thoughts, they might be having an anxiety disorder and it is necessary, to begin with, therapy as a way of providing recovery help. Hassiotis, Serfaty, Azam, Strydom, Martin, Parkes, and King, (2011) identify that CBT is among the most successful treatments for anxiety. As articulated by Spector, Orrell, Lattimer, Hoe, King, Harwood, and Charlesworth, (2012) in the treatment of anxiety, CBT involves face to face talk; whereby the patient is taken through around eight sessions combined or not combined with medication. Wood, McLeod, Piacentini, and Sigman, (2009) agree with the authors and add that in the current world, the conduct of online CBT can offer successful practical and acceptable health care, especially for the individuals who are likely to remain untreated. Besides, a therapist tries to intervene through changing one's harmful thought patterns, guiding them towards the relaxation skills, and changing performances that result in the worsening of the psychological problem. Hadwin and Richards (2016) argue that CBT works through the identification and addressing of the manner in which an individual's behaviors and thoughts interact to generate anxiety. Hofmann and Smits (2008) have the same perception and identify that in the process, therapists tend to collaborate with the patient to realize how the undesirable thought patters affect a patient’s behavior and feelings. Indeed, CBT is the initial step in the treatment of anxiety, as it enhances motivation for treatment, provision of psychoeducation, and getting the patient on board.
The Effectiveness of CBT in Anxiety Disorders
CBT is an effective method in the treatment of anxiety disorders with or without the provision of medication to the patient. According to the study by Spector et al., (2012), CBT is widely used in the management of many populations with mental disorders. Also, Spector et al., (2012) identify that people who are suffering from dementia recover easily when CBT is used for their anxiety problems, as the therapy helps in the reduction of anxiety, night awakenings, alcohol intake and enhancement of mood and contribution in delightful activities. Hence, CBT does not only help a patient to reduce his or her anxiety but also enables one to live a better life in the future.
Child-based anxiety requires the application of CBT with the involvement of the parents. Wood et al., (2009) find out that family-based cognitive behavioral therapy (FCBT) and child-focused cognitive behavioral therapy (CCBT) are effective in the treatment of child anxiety disorders within one year. Wood et al., (2009) assert that the moment a parent and child engage in negotiation with each other on issues affecting the life of the child, this enables a child to recover quickly. However, as postulated by Spector et al., (2012), the parenting behavior matters a lot in the effectiveness of FCBT. Through the comparison of FCBT and CCBT Wood et al., (2009) identify that FCBT is more effective than CCBT because of the consideration of the parenting conduct which contributes towards the development of anxiety in a child. Therefore, FCBT and CCBT are effective in treating child anxiety but needs paying attention to the parental behavior.
The usage of CBT in combination with other psychological treatment methods is highly fruitful on anxiety disorder recovery. Nonetheless, Cape et al., (2010) argue that when CBT is combined with problem-solving therapy and counseling, it becomes highly effective in treating patients with mixed anxiety and depression. The same is recognized by Hadwin and Richards (2016) who state that CBT and the provision of training for working memory work effectively in the reduction of anxiety symptoms. Hadwin and Richards (2016) identify that cognitive theories including the attention control theory help in understanding the negative relationship between cognition and anxiety when using CBT to assist individuals with elevated anxiety leading to undesirable feelings. Also, Hadwin and Richards (2016) assert that when using CBT in the treatment of anxiety, therapists need to understand the rising symptoms and means of improving the attentional control since this guides one towards the means of meeting the set goals. Therefore, when applied well and with a focus, CBT effectively helps in the recovery of people suffering from anxiety disorders irrespective of age.
CBT is tolerable, speedy, and efficient in handling anxiety cases. In the study by Bontempo, Panza, and Bloch, (2012), it was found that in the treatment of anxiety disorders such as obsessive-compulsive disorder (OCD), panic disorder, social phobia, and specific phobia; different behavior therapies are applied, although CBT is the first-line intervention applied by therapists. Bontempo, Panza, and Bloch, (2012) through a meta-analysis of randomized, controlled trials of CBT for anxiety disorder realize that the participants getting CBT were 4-fold more possible to react to treatment as compared to the ones acquiring placebo. The results of their study concluded that anxiety patients treated using CBT for a prolonged moment they tend to realize some improving results (Hofmann and Smits 2008). Indeed, after agreeing to participate in several CBT sessions, it is definite that a patient would achieve a significant reduction in anxiety.
CBT is always linked to some positive recovery experience because of the reduction of anxiety in a patient. In a study by Allen, White, Barlow, Shear, Gorman and Woods, (2010), the clinical performance of CBT is associated with positive treatment outcomes, especially in the handling of panic disorder because the therapy works effectively in the elimination of depressive and comorbid anxiety signs. Allen et al., (2010) postulate that the treatment results for panic disorder with depression and anxiety comorbidity are positive because CBT works through different mechanisms including the provided skills, and panic symptoms being the major cause for anxiety. Positive thinking is another aspect identified by Bontempo, Panza, and Bloch, (2012) to be applicable in CBT on anxiety. Allen et al., (2010) also realize that CBT targets on the broader issues that regulate and associated with emotions, therefore becoming effective in handling anxiety disorders, which are related to the development of negative emotions. Indeed, CBT is more effective in helping patients with anxiety because of hasty changing of emotions.
When treating patients with long-term anxiety and other psychotic symptoms, CBT is successfully used. Hassiotis et al., (2011) performed a pilot randomized controlled trial and realized that CBT works well for depression and anxiety in adults with mild intellectual disabilities (ID). Compared with treatment as usual (TAU), CBT in people suffering from anxiety and with intellectual disabilities, results to the desirable outcomes, especially when the patients have engaged in around ten therapy sessions (Hassiotis et al., 2011). CBT is a preferred method in the treatment of anxiety disorders because therapists focus on valuing the decisions and feelings of individuals by involving them in the entire treatment process (Hassiotis et al., 2011). Andersson, Carlbring, Furmark and SOFIE Research Group, (2012) argue the same that in the provision of treatment on anxiety disorder, CBT operates more effective because of self-help; whereby the patient is required to make a personal decision for positive change of behavior and feelings. Therefore, in the treatment of people with psychological problems such as anxiety and intellectual disability, CBT works better compared with TAU.
CBT is regularly used in different adult anxiety disorders. In their computerized search, Hofmann and Smits (2008) identify that treatment of anxiety disorders using CBT is efficacious and associated with the desired outcomes. As compared to placebo, CBT has a higher level of efficacy even after the patient is taken through a few therapy sessions Cape et al., 2010). The same findings are identified by Andrews et al., (2010), who state that CBT saves time, energy, and cost for both the patient and therapist. According to the argument put forth by Hofmann and Smits (2008), CBT is practiced in a set of interventions with the fundamental premise that psychological and emotional disorders are retained by cognitive aspects and the understanding that mental treatment results to outcomes in the particular dynamics through behavioral and cognitive techniques. Hofmann and Smits (2008) emphasize that the behavioral techniques applied in CBT on anxiety are; social skills education, relaxation training, behavioral tests, and exposure.
Computerized CBT and Historical Face-to-Face CBT on Anxiety
In the contemporary world, many things are done through a computer including the provision of healthcare services. Andrews, Cuijpers, Craske, McEvoy, and Titov, (2010) conduct a metal analysis study concerning the application of computerized therapy for depressive disorders and anxiety. In their research, Andrews et al., (2010) realize that traditional face-to-face CBT and computerized CBT are similarly beneficial for anxiety. However, they concluded that computerized CBT performed through the internet can offer successful practical and acceptable health care for the individuals who do not seek treatment. Andrews et al., (2010) argue that the computerized mental treatments for anxiety states are recently common and help in cases where patients fail to start treatments. Moreover, Andrews et al., (2010) assert that the application of computerized CBT reduces the clinician time and improves treatment convenience, thus becoming acceptable and efficacious treatment equally with face-to-face treatment. A patient’s adherence to the computerized CBT is good because it is flexible and allows the patient to interact with therapists and state his or her problems similarly with face-to-face CBT (Andrews et al., 2010). Hence, computerized CBT and face-to-face CBT are equally beneficial in the treatment of anxiety disorders.
Internet-delivered CBT on social anxiety disorder (SAD) is highly effective in the reduction of symptoms of the disorder. According to a study by Andersson et al., (2012), the guided internet-delivered CBT has a large impact in the elimination of signs and symptoms of SAD, improving therapist skills and experience, and enhancing knowledge concerning SAD. When therapists are guiding patients on how to control their feelings and emotions, internet-based cognitive-behavior therapy (ICBT) supports them with the required knowledge and experience. Also Andersson et al., (2012) articulate that the application of the internet is helpful for the patients with SAD because of the access to self-help manuals and guidance on how to handle the homework assignments. ICBT promotes the patients and therapist’s learning although an experienced therapist performs better than the inexperienced therapist (Andersson et al., 2012). As patients are engaged in online discussion forums, they have the opportunity to discuss their negative feelings and thoughts, and through sharing of the personal experience, this helps them to individually control their behavior Andersson et al., 2012). Therefore, ICBT works effectively in the treatment of anxiety disorders because of the gained knowledge and experience in the performance of self-help practices.
Conclusion
CBT is an effective way of treatment of anxiety disorders. According to the literature, therapists practicing CBT help their clients to realize the desired outcomes quickly and efficiently. This therapy works well for both the adults and children with anxiety because it is a self-help aspect of recovery from the disorder. The literature has widely identified the benefits related to the practice of Internet-based CBT and face-to-face CBT. It is clear that long-term involvement in CBT helps a patient to experience significant reduction of anxiety even without taking medication or going for other treatments. However, it would be necessary to perform a study concerning the effectiveness of CBT in the cases of anxiety relapse. Since some people experience the reoccurrence of the anxiety disorders, it is vital to identify how the CBT therapist would assist in such cases. Therefore, researchers need to pay attention in investigating the way in which CBT can be used to manage the recurring anxiety disorders.
References
Allen, L. B., White, K. S., Barlow, D. H., Shear, M. K., Gorman, J. M., " Woods, S. W. (2010). Cognitive-behavior therapy (CBT) for panic disorder: Relationship of anxiety and depression comorbidity with treatment outcome. Journal of Psychopathology and Behavioral Assessment, 32(2), 185-192.
Andersson, G., Carlbring, P., Furmark, T., " SOFIE Research Group. (2012). Therapist experience and knowledge acquisition in internet-delivered CBT for social anxiety disorder: a randomized controlled trial. PloS one, 7(5), e37411.
Andrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., " Titov, N. (2010). Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PloS one, 5(10), e13196.
Bontempo, M. A., Panza, M. K. E., " Bloch, M. H. (2012). Meta-Analysis: D-cycloserine augmentation of behavioral therapy for the treatment of anxiety disorders. The Journal of clinical psychiatry, 73(4), 533.
Cape, J., Whittington, C., Buszewicz, M., Wallace, P., " Underwood, L. (2010). Brief psychological therapies for anxiety and depression in primary care: meta-analysis and meta-regression. BMC Medicine, 8(1), 38.
Hadwin, J. A., " Richards, H. J. (2016). Working memory training and CBT reduces anxiety symptoms and attentional biases to threat: A preliminary study. Frontiers in psychology, 7, 47.
Hassiotis, A., Serfaty, M., Azam, K., Strydom, A., Martin, S., Parkes, C., ... " King, M. (2011). Cognitive behaviour therapy (CBT) for anxiety and depression in adults with mild intellectual disabilities (ID): a pilot randomised controlled trial. Trials, 12(1), 95.
Hofmann, S. G., " Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. The Journal of clinical psychiatry, 69(4), 621.
Spector, A., Orrell, M., Lattimer, M., Hoe, J., King, M., Harwood, K., ... " Charlesworth, G. (2012). Cognitive behavioural therapy (CBT) for anxiety in people with dementia: study protocol for a randomised controlled trial. Trials, 13(1), 197.
Wood, J. J., McLeod, B. D., Piacentini, J. C., " Sigman, M. (2009). One-year follow-up of family versus child CBT for anxiety disorders: Exploring the roles of child age and parental intrusiveness. Child Psychiatry and Human Development, 40(2), 301-316.
