Cognitive-behavioral therapy is recognized as one of the most effective treatments for anxiety disorders. As the name suggests, it focuses on cognitions and behaviors and how they are related. Anxiety is produced by a cycle of negative thoughts and maladaptive behaviors that can interact and feed into each other. Therapy works by interrupting this destructive cycle.
Theory
Cognitive-behavioral theory involves the interplay of thoughts, feelings and behavior. Your thoughts influence your feelings and emotions, which result in behavior. You may get up to sing in front of a crowd and see a group of people ready to support and encourage you. Someone else may see the same crowd as full of people ready to ridicule and jeer. These different perceptions lead to different emotions, such excitement versus anxiety. Body signals can also be misperceived. You may notice your racing heart and sweaty palms and think "Whoo-hoo ... I'm ready to go." Another person may interpret these signals as "Oh no ... I'm going to fall apart." These thoughts can become a self-fulfilling prophecy.
Features
Cognitive-behavioral therapy will focus on examining and restructuring your negative thought patterns. Negative thoughts distort your perception of yourself and the situation. Examples include: "I can't control myself," "Everyone hates me," "I got a bad grade, therefore I am a bad student," "You must be lying if you say I am attractive." You will also learn coping skills to help you manage your anxiety and change your behavior. Relaxation is a core skill. This begins with learning how to control your breathing. Then you are taught progressive relaxation and how to control body tension. Additional skill sets include social skills and assertiveness skills.
Effects
Many people experience situation-specific anxiety or phobias. Using systematic desensitization, a therapist will work with you to create a detailed hierarchy of fears on a 1-100 scale. For example, singing alone may produce 0 feelings of anxiety, whereas singing in front of a crowd of strangers may be 100. Using your new coping skills, you will work gradually through the hierarchy. You overcome the anxiety by experiencing the fear step by step, learning to calm yourself and realizing that you really are OK.
Considerations
Cognitive-behavioral therapy is most effective when skills are practiced outside of session. You will be asked to document your thoughts, feelings and behaviors in between sessions. You may also be asked to confront your anxiety. For example, if you fear social situations, you might be asked to introduce yourself to two new people and discuss the experience during the following session.
Time Frame
Depending on the type and severity of anxiety, length of treatment usually ranges from eight to 20 sessions. If your anxiety is mild, you may be able to learn some of the basics on your own using self-help workbooks. However, if your anxiety affects your ability to function or causes significant distress, consult a professional.
