Are there evidence-based treatments for anxiety?
Here are some of the evidence-based treatments for anxiety that you may want to consider. It is normal for people to get anxious from time to time but some people experience it more frequently and a lot more forcefully. Sometimes, it comes to the point that anxiety has taken over their lives.
Should exposure-based therapies be the first-line treatment for anxiety disorders?
Over a quarter of the people in the US population will have an anxiety disorder sometime during their lifetime, and available research literature suggests that exposure-based therapies should be considered the first-line treatment for these disorders.
What is the research on CBT in anxiety disorders?
In summary, the research on CBT in anxiety disorders supports the efficacy and effectiveness of these methods, with most of the current research demonstrating the usefulness of providing exposure therapy in the treatment of anxiety disorders.
What are evidence-based treatments for generalized anxiety disorder (GAD)?
This article looks at three evidence-based treatments that can help you manage Generalized Anxiety Disorder and other related disorders. When we talk about evidence-based therapy, we are referring to treatments that are proven to have a benefit, based on peer-reviewed scientific evidence. They are: Cognitive Behavioral Therapy (CBT)
How does DBT help with PTSD?
DBT teaches skills to help control harmful and impulsive behaviors such as self-harming, substance misuse, and binge eating; reduce suicidal thoughts and behaviors; and improve symptoms of PTSD , depression, and borderline personality disorder. This treatment can also help patients build and maintain healthy relationships and may be particularly well-suited for people who experience a lot of conflict in relationships with frequent ups and downs. DBT uses a combination of acceptance and change strategies to help you learn new problem-solving and coping skills to improve your overall quality of life.
How long does CBT-D last?
Typically lasting from 12 to 16 sessions, CBT-D can help you reach your treatment goals. Through this therapy, you may:
What is BA therapy?
BA is a therapy that has been shown to relieve or resolve symptoms of depression. This therapy will help you become more engaged with activities that can improve your mood.
How long does CPT therapy last?
CPT typically lasts from seven to 15 weekly sessions, either in an individual or a group setting, depending on your preference. Through this therapy, you may:
What are the best treatments for anxiety?
These treatments can be broadly categorized as: 1) Psychotherapy; 2) Medications; and 3) Complementary and Alternative Therapies. Patients diagnosed with anxiety can benefit from one ...
How to treat anxiety?
Anxiety is associated with abnormal patterns of activity in the brain. One way to treat anxiety is to directly target abnormal nerve cell activity. Neuromodulation or brain stimulation therapy is a non-invasive and painless therapy that stimulates the human brain.
How does CBT help with PTSD?
CBT primarily focuses on the ongoing problems in a patient's life and helps them develop new ways of processing their feelings, thoughts and behaviors to develop more effective ways of coping with their life. In patients who suffer from PTSD, CBT can take on a trauma-focused approach, where the goal is to process and reframe the traumatic experience that lead to the symptoms. On average, the length of treatment is around 10-15 weekly one-hour sessions depending on the type and severity of symptoms.
What is act therapy?
ACT is a type of CBT that encourages patients to engage again in positive behaviors even in the presence of negative thoughts and behaviors. The goal is to improve daily functioning despite having the disorder. It is particularly useful for treatment-resistant Generalized Anxiety Disorder and Depression. The length of treatment varies depending on the severity of symptoms.
How does DBT work?
DBT uses a skills-based approach to help patients regulate their emotions. It is a prefered treatment for Borderline Personality Disorder, but call also be effective for anxiety disorders such as PTSD. This treatment teaches patients how to develop skills for how to regulate their emotions, stress-management, mindfulness, and interpersonal effectiveness. It was developed to be employed in either one-on-one therapy sessions or group sessions. This type of therapy is typically long-term and patients are usually in treatment for a year or more.
What is complementary therapy?
Complementary and Alternative Therapies can be used in conjunction with conventional therapies to reduce the symptoms of anxiety. There is a growing interest in these types of alternative therapies, since they are non-invasive and can be useful to patients. They are typically not intended to replace conventional therapies but rather can be an adjunct therapy that can improve the overall quality of life of patients.
What is mindfulness practice?
A mind and body practice in which individuals are instructed to be mindful of thoughts, feelings and sensations in non-judgmental way. It has been shown to be useful in reducing the symptoms of psychological stress in patients with anxiety.
What is self efficacy theory?
The self-efficacy theory focuses more on increasing skills and mastery over a situation or performance than on reducing a fear response directly. 38 Persons with anxiety disorders tend to underestimate their capabilities to cope with fear.
What is exposure therapy?
Exposure therapy is defined as any treatment that encourages the systematic confrontation of feared stimuli, with the aim of reducing a fearful reaction. Over a quarter of the people in the US population will have an anxiety disorder sometime during their lifetime, and available research literature suggests that exposure-based therapies should be ...
What is cognitive restructuring?
Cognitive restructuring refers to identifying and challenging irrational, unrealistic, or maladaptive beliefs. In patients with anxiety disorders, 2 of the more common faulty thinking patterns (ie, cognitive distortions) are probability overestimation and catastrophizing.
How long does exposure therapy last?
20,21 st 22 examined the effects of single-session in vivo exposure (that lasts 1 to 3 hours) for patients with specific phobias. At posttreatment follow-up (after an average of 4 years), 90% of these patients still had significant reduction in fear, avoidance, and overall level of impairment and 65% no longer had a specific phobia.
Which receptor is responsible for the extinction of fear?
Biologically, the extinction of fear appears to be mediated by N -methyl-d-aspartate receptor activity in the basolateral amygdala, a finding that has led to the use of neuroplasticity compounds such as d-cycloserine to augment exposure. 28,29 There are 4 major theories that attempt to explain the psychological mechanisms of exposure therapy: habituation, extinction, emotional processing, and self-efficacy ( Table 2 ).
Is exposure therapy the first line of treatment for anxiety?
The available research literature suggests that exposure-based therapy should be considered the first-line treatment for a variety of anxiety disorders. Here we review a handful of the most influential studies that demonstrate the efficacy of exposure therapy. We also discuss theoretical mechanisms, practical applications, and empirical support for this treatment and provide practical guidelines for clinicians who wish to use exposure therapy and empirical evidence to guide their decision making.
Is exposure therapy effective for anxiety?
Exposure Therapy for Anxiety Disorders. Exposure-based therapies are highly effective for patients with anxiety disorders, to the extent that exposure should be considered a first-line, evidence-based treatment for such patients. In clinical practice, however, these treatments are underutilized, which highlights the need for additional ...
What is a skill-based coping toolbox?
SKILL-BASED: We work with our patients to build a toolbox of unique cognitive and behavioral coping strategies to address presenting concerns and also teach them how these tools can be utilized as lifelong skills. Our clinicians are experts in determining the most effective strategies to fill the toolbox and present them in a way that is accessible, relatable, and matched to the patient’s learning style.
What is cognitive behavioral therapy?
Cognitive Behavioral Therapy (CBT) Cognitive Behavioral Therapy (CBT) focuses on exploring relationships between a patient’s thoughts, feelings, and behaviors, as well as contextual and environmental factors that may be contributing to the patient’s distress.
What is CBT therapy?
CBT, more specifically, Exposure and Response Prevention (ERP) / Exposure Therapy, is the gold-standard treatment for Anxiety Disorders, Obsessive-Compulsive Disorder (OCD), and related concerns.
How to treat anxiety disorders?
Cognitive therapy is another widely used method for treating anxiety disorders. Cognitive therapy is based on Beck's tri-part model of emotion which proposes that thoughts, feelings, and behaviors are interrelated. Aceording to this theory, changing maladaptive thoughts is proposed to alter the patienfs maladaptive affect and behavior. Cognitive therapy targets distorted thoughts using a number of techniques such as identifying inaccu rate thinking, examining the evidence for and against automatic thoughts, challenging and changing maladaptive thoughts, altering problematic behaviors, and relating to other people in more adaptive ways. Psychoeducation about the tri-part model of emotion, the different forms of distorted thinking (eg, all-or-nothing thinking, jumping to conclusions, disqualifying the positive, etc), and cognitive restructuring is an integral part of cognitive therapy . Homework is typically assigned to give patients opportunities to practice these skills in their daily life, allowing them to gain mastery of the techniques so they will be able to apply what they have learned after treatment has ended. In treating anxiety disorders, cognitive therapy is most often used in conjunction with behavioral techniques, which may include exposure exercises. Cognitive therapy is typically time-limited to about 20 sessions or less, and is problem-focused on the issues the patient identifies as of primary concern.
How effective is cognitive therapy for anxiety?
The use of cognitive techniques in treating anxiety disorders is widely implemented. Yet the research on the efficacy and effectiveness of cognitive techniques alone for anxiety disorders has shown variable results. For example, a study comparing transdiagnostic CBT therapy with relaxation training in anxiety disorder patients found both treatments to be equally beneficial, although relaxation training was associated with a higher dropout rate.38The results regarding the efficacy and effectiveness of cognitive therapy for anxiety disorders are also limited by the small number of studies examining cognitive methods in isolation from exposure. Many of the treatment protocols investigated in treatment outeome studies combine both exposure and cognitive therapy techniques, making conclusions about the relative contributions of each method difficult to disentangle.
What is exposure based CBT?
Exposure-based techniques are some of the most commonly used CBT methods used in treating anxiety disorders. One theoretical framework for understanding the rationale for exposure-based treatment cornes from emotional processing theory.10According to emotional processing theory, fear is represented by associative networks (cognitive fear structures) that maintain information about the feared stimulus, fear responses (eg, escape, avoidance, psychophysiological responses), and the meaning of the stimuli and responses (eg, tiger = danger, increased heart rate = heart attack). When a stimulus in the environment is encountered that resembles the feared stimulus, these associative networks activate the fear structure. The fear structure is pathological when the relationship among stimuli, responses, and their meaning do not match reality, such as when it is activated for safe stimuli or responses that resemble the feared ones. Furthermore, the fear structure is maintained by avoidance behaviors which do not allow for new learning to occur.
How does exposure affect the fear structure?
Exposure is proposed to modify the pathological fear structure by first activating it and then providing new information that disconfirms the pathological, unrealistic associations in the structures (eg, tachycardia does not lead to heart attack, crowded malls do not lead to violent attack). By confronting the feared stimulus or responses and integrating corrective information in the fear memory, fear is expected to decrease. Exposure can take several forms including imaginal, in vivo (in real life), and interoceptive. Imaginal exposure occurs when the patient vividly imagines the feared situation/consequences and does not avoid their subsequent anxiety. In vivo exposure involves graduai approach to places, objects, people, or situations that were previously avoided although they are safe. Interoceptive exposure, which is mostly used in treating panic disorder, involves deliberately inducing the physical sensations the patient fears are indicative of a panic attack. these exposure techniques are similar in their function because they allow the patient to acquire new learning in order to modify the fear structure. In general, exposure therapy is of limited duration and is typically completed in about 10 sessions.
What is EX/RP therapy?
EX/RP, also a primarily exposure-based therapy, integrates cognitive processing following or during exposure to allow OCD patients to gain insights regarding their feared consequences .18How ever, EX/RP does not mandate the use of any specific cognitive techniques. Cognitive therapy protocols for OCD often involve identifying and altering distorted cognitive beliefs about the significance of intrusive thoughts (eg, intrusive thoughts mean the patient is a bad person). For example, a cognitive therapy protocol tested by McLean and colleagues begins with psychoeducation about OCD symptoms and an introduction to the treatment rationale.48Patients are then engaged in a discussion about the relationship between triggers that lead to intrusive thoughts and the patients faulty appraisals of these thoughts which leads to anxiety and urges to perform compulsions. Patients are then taught to recognize the different types of distorted appraisals including overimportance of thoughts, overestimation of danger, inflation of responsibility, overestimation of the consequences of danger, overestimation of the consequences of responsibility, and need for certainty-control-perfectionism.48Patients then began challenging these faulty appraisals by conducting behavioral experiments to test the evidence for and against their beliefs.
What is cognitive behavioral therapy?
F. Skinner and Joseph Wolpe, who pioneered the behavioral therapy movement in the 1950s. Behavioral therapy supposes that changing behaviors leads to change in emotions and cognitions such as appraisals. Since its introduction, behavioral therapy has evolved to include cognitive psychotherapy, pioneered by the early work of psychologists such as Albert Eilis and Aaron T. Beck. Cognitive therapy focuses on changing cognitions, which is proposed to change emotions and behaviors. Subsequently, the terms cognitive therapy, behavioral therapy, and cognitive-behavioral therapy have emerged. For the purposes of parsimony and to facilitate discussion of this diverse set of treatments, in this article we group the cognitive and behavioral therapies under the umbrella term “CBT” while acknowledging that the relative emphasis of cognitive vs behavioral techniques differs across treatment programs.
How many sessions of cognitive therapy are needed for anxiety?
Cognitive therapy is typically time-limited to about 20 sessions or less, and is problem-focused on the issues the patient identifies as of primary concern.
Which treatment has the greatest efficacy in reducing sexual recidivism?
For sexual offenders in particular, physical treatments, such as surgical castration and hormonal treatment, were demonstrated to have greater efficacy in reducing sexual recidivism in comparison to CBT, with large significant odds ratios for both of these alternative interventions (Lösel & Schmucker, 2005). Of the various psychological interventions for sexual offenders, however, classical behavioral and CBT approaches indicated the strongest efficacy, with odds ratios in the medium to large range (Lösel & Schmucker, 2005) as compared to insight-oriented and therapeutic community interventions.
What is the goal of CBT?
Consistent with the medical model of psychiatry, the overall goal of treatment is symptom reduction, improvement in functioning, and remission of the disorder. In order to achieve this goal, the patient becomes an active participant in a collaborative problem-solving process to test and challenge the validity of maladaptive cognitions and to modify maladaptive behavioral patterns. Thus, modern CBT refers to a family of interventions that combine a variety of cognitive, behavioral, and emotion-focused techniques (e.g., Hofmann, 2011; Hofmann, Asmundson, & Beck, in press). Although these strategies greatly emphasize cognitive factors, physiological, emotional, and behavioral components are also recognized for the role that they play in the maintenance of the disorder.
How effective is CBT for smoking cessation?
Treatments for smoking cessation found that coping skills , which were partially based on CBT techniques, were highly effective in reducing relapse in a community sample of nicotine quitters (Song, Huttunen-Lenz, & Holland, 2010), and another meta-analysis noted superiority of CBT (either alone or in combination with nicotine replacement therapy) over nicotine replacement therapy alone (Garcia-Vera & Sanz, 2006). Furthermore, there was evidence for superior performance of behavioral approaches in the treatment of problematic gambling as compared to control treatments (Oakley-Browne et al., 2000). One meta-analysis (Leung & Cottler, 2009) reported larger effect sizes of CBT when this treatment was grouped with other non-pharmacological treatments (such as brief interventions) as compared to pharmacological agents (e.g. naltrexone, carbamazepine, and topiramate), but CBT was not more efficacious than these other briefer, less expensive approaches.
What are the major groups of meta-analyses?
The major groupings were the following: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, pregnancy complications and female hormonal conditions. In addition, some meta-analyses specifically examined CBT for disorders in children and elderly adults. For each disorder and population grouping, data were described qualitatively, considering the findings of all meta-analyses within that group. The 269 meta-analyses included a wide variety of studies that employed different methodologies and effect size estimates. Therefore, we used the designation small, medium, and largefor the magnitude of effect sizes in our review of the 106 representative meta-analyses (Cohen, 1988). In addition, we provide reported response rates, a widely accepted and common metric in psychiatry, from a subsample of 11 studies that examined the efficacy of CBT in randomized controlled trials.
What is cognitive behavioral therapy?
Cognitive-behavioral therapy (CBT) refers to a class of interventions that share the basic premise that mental disorders and psychological distress are maintained by cognitive factors. The core premise of this treatment approach, as pioneered by Beck (1970)and Ellis (1962), holds that maladaptive cognitions contribute to the maintenance of emotional distress and behavioral problems. According to Beck’s model, these maladaptive cognitions include general beliefs, or schemas, about the world, the self, and the future, giving rise to specific and automatic thoughts in particular situations. The basic model posits that therapeutic strategies to change these maladaptive cognitions lead to changes in emotional distress and problematic behaviors.
Why was the search strategy restrictive?
However, the search strategy was restrictive, because only one meta-analysis was selected for each disorder. Furthermore, the search only covered the period up to 2004, but many reviews have been published since then. In fact, the majority of studies (84%) was published after 2004.
Is CBT effective for bipolar?
These findings emerged from examinations of both manic and depressive symptoms associated with bipolar disorder (e.g., Gregory, 2010a, 2010b). There is little evidence that CBT as a stand-alone treatment (rather than as an adjunct to pharmacotherapy) is effective for the treatment of bipolar disorder .
Evidence-Based Therapies
- Counseling
Counseling is a form of talk therapy in which a mental healthcare provider helps patients develop strategies and coping skills to address specific issues like stress management or interpersonal problems. Counseling is generally designed to be a short-term therapy. - Psychotherapy
There are many types of psychotherapies used to treat anxiety. Unlike counseling, psychotherapyis more long-term and targets a broader range of issues such as patterns of behavior. The patient's particular anxiety diagnosis and personal preference guides …
Medications
- Medications are sometimes used in conjunction with psychotherapy. The most commonly prescribed medicationsare generally safe, although some do have side effects to consider. The specific type of medication administered to patients will be determined by their providers based on the patient's specific symptoms and other factors like general health.
Complementary and Alternative Therapies
- Complementary and Alternative Therapies can be used in conjunction with conventional therapies to reduce the symptoms of anxiety. There is a growing interest in these types of alternative therapies, since they are non-invasive and can be useful to patients. They are typically not intended to replace conventional therapies but rather can be an adjunct therapy that can improv…
Emerging Therapies
- There are also a number of experimental treatments that have shown promise in treating the symptoms of anxiety. Here we include a brief description of a few of those, including brain stimulation (neurostimulation), acupuncture, and psychoactive drugs (marijuana and ecstasy).
Types of Care Providers
- There are a number of different types of licensed mental health providers that can treat the range of anxiety and other related disorders.
Where to Find Treatment
- Most treatment providers for anxiety-related disorders can be found in hospitals, clinics, private or group practices. Some also operate in schools (licensed mental health counselors, clinical social workers, or psychiatric nurses ). There is also the growing field of tele-health in which mental health workers provide their services through an internet video service, streaming media, video c…
What Do We Mean by Evidence-Based Practices?
Advantages and Disadvantages
Real-World Therapy Is Not Research Therapy
Client Goals Don’T Always Match Evidenced-Based Research
The Therapist (and The Client) Matters
- Just because a therapist follows an evidence-based treatment does not mean that the therapy will be effective. For example, a therapist and a client may not get along, causing a lack of rapport, which reduces the treatment efficacy. Or, a therapist might be distracted by personal challenges and not put in the necessary effort toward their sessions....
Most Relevant Evidence-Based Practices
The Role of Evidence-Based Practices in Psychotherapy