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How CBT Can Help Treat Your Anxiety
How CBT Can Help Treat Your Anxiety
It’s quite normal to feel anxious at times. You may feel anxious about a job interview or a school assignment. In certain circumstances, anxiety can be beneficial. Anxiety can help you recognize situations that may be potentially dangerous or frightening, activating your fight or flight response.
So how do we know when anxiety is harmful? When your anxiety goes beyond simple nervousness—when it interferes with your everyday tasks, when you experience fear or dread and you can’t control your reactions to situations, or when you have trouble making it through the day. If any or all occur for you, it may be time to seek therapy for your anxiety. Anxiety disorders are the most common psychiatric disorders. They can greatly diminish the quality of life and can lead to premature death. Unfortunately, anxiety disorders are commonly overlooked and undertreated.
There are many types of treatments for treating anxiety disorders including social anxiety disorder. More than mere shyness, social anxiety disorder is the intense and persistent fear of being watched or judged. The most common treatment of anxiety is cognitive-behavioral therapy (CBT), medication, or a combination of both. Which approach is most effective?
Treating anxiety disorder with or without medication
According to Dr. Cai Chen, psychiatrist and Level II certified TEAM-CBT therapist at the Feeling Good Institute, while antidepressants such as Paroxetine are helpful and commonly used to treat social anxiety disorder, new research suggests one particular approach that is most effective. He points to a 2016 randomized clinical trial by Hans M. Nordahl, professor in clinical psychology and behavioral medicine at the Norwegian University of Science and Technology in Trondheim, Norway, and colleagues who found that CBT alone is more effective for treating social anxiety disorder compared to medication alone or in combination with CBT.
Another study was led by Evan Mayo-Wilson, DPhil, a research scientist in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. He and his colleagues analyzed data from 13,164 participants with social anxiety disorder over 101 clinical trials. They also found that, compared to medication alone or a combination of CBT and medication, CBT alone is the most effective treatment of social anxiety.
Cognitive-Behavioral Therapy or CBT is the most widely-used, evidence-based treatment for anxiety. It’s very well-known and extensively used because it has been studied so comprehensively. The reason CBT is so effective at treating anxiety is that it is about learning how to change your negative perceptions by creating more balanced alternative thoughts. Basically, CBT is about how your thoughts—not any external event—relate to how you feel. That is to say, it’s not a particular situation that brings about your anxiety, but it’s your perception or your thoughts about the situation that causes your anxiety.
What are the benefits of CBT?
- Goal-oriented - CBT for anxiety is effective because it uses your relationship between your thoughts and behaviors in order to make gradual changes. You set treatment goals with your provider who will help you navigate to that goal in a realistic and tangible manner.
- Time-limited - It’s also time-limited, which means you will know when the treatment will begin and end. In other words, CBT strives to produce clear, measurable changes in thoughts and behavior in a timely manner.
- Boosts self-esteem – each time you achieve a new goal, your self-esteem grows. Breaking your negative thought patterns will enable you to shift your entire belief system giving you a more positive outlook.
- Gives you hope – when you break the cycle of negative thinking, a whole new world of possibilities opens up before you.
- Helps you learn life lessons – CBT will teach you the skills to think more positively. Whenever challenges arise in the future, you’ll have the skills you need to combat your old negative thought patterns.
How does it work?
CBT is a type of talk therapy that helps people recognize and change their harmful thought patterns that lead to their negative behaviors and emotions. CBT is based on the idea that your thoughts, emotions, and actions are all connected.
Unlike psychoanalysis which may delve into your past, CBT focuses on your current problems and finds solutions for them by taking a problem-oriented strategy. And unlike medication, CBT can have lasting results long after treatment has stopped because this type of therapy teaches you the skills you need to tackle challenges on your own for the rest of your life.
Sessions typically begin with the therapist having you fill out a survey to get a better idea of how you are feeling in terms of depression, anxiety, suicidality, happiness and relationship satisfaction. As sessions get underway, you’ll be given homework that your therapist will discuss with you and cover any loose ends. Your therapist will then focus on one specific aspect of your issue that you’d like to work on. At the end of each session, you’ll be given more homework, again, depending on what you want to work on. At the end of each session, you’ll fill out another survey to see if your mood/anxiety scores have changed. Your therapist will also ask you to rate how well they’ve helped you that day. This will allow your therapist to determine how to best address your needs in the following session by fine tuning your treatment.
Homework is important because you can do CBT on your own. Think of CBT as your personal trainer for your anxiety or other issues. You will get fine-tuned support and guidance during your sessions and an effective “learning plan” to be done in between sessions. When you recover, your therapist will tell you exactly what techniques worked for you and create a relapse prevention plan for you. All you'd have to do is pick up those same tools the next time you relapsed, and you'd recover again. Each relapse will be an opportunity to improve, and you won't "need" the therapist anymore unless there was a problem you couldn't handle on your own.
In terms of how many sessions you can expect, that depends. For example, some people with anxiety can recover within 1-3 hours (under very ideal conditions). Others require more support, persistence, and a lot of hard work which can easily take weeks-months. There's no way to predict ahead of time how long it will take for each person. In general, how fast someone recovers is dependent on two factors: how hard they're willing to work for their recovery, and how willing they are to try new things no matter how negatively they feel or how much they don't want to do it at first. It's also dependent on the skill of the therapist.
If the therapist is also scared of what the patient is anxious of, they may be less effective with their patients. A therapist who has both the heart and technical skills can communicate to you: "I've been there too, I know how much it sucks. That's why I'm so happy you're here because I love treating anxiety. I'd be more than happy to show you how to beat this." Dr. Chen, for example, used to have moderate-severe social anxiety, generalized anxiety, OCD, and panic attacks. He used all the same techniques and tools he teaches to his patients to help himself. Because of that experience, he is now able to carry the confidence he built from those experiences with the patients he works with.
CBT in psychology
The psychology behind CBT is based on these key principles:
Every time this cycle repeats, the negative thoughts, feelings, and behaviors are reinforced. Much like learning a new skill such as learning a new language or picking up a musical instrument, CBT will teach you new ways of looking at your beliefs in order to change the way you think about a situation.
CBT treatment of anxiety usually involves short-term strategies to change negative thought patterns. There are several techniques to use. You and your therapist will work together to come up with a strategy that targets your specific needs. Here are a few CBT techniques:
- Cognitive restructuring – this is where you take a hard look at your negative thought patterns. Once you recognize these patterns, you can learn how to reframe them in a more positive way.
- Motivational Interviewing and Assessment – this is where your therapist will discuss with you on why it’s so hard to let go of your anxiety. You’ll discover that, while painful and scary, your anxiety has very real benefits and positive things that it says about your core values and who you are as a human being. The moment you realize how great your anxiety is will also be the moment you won’t need it anymore.
- Guided discovery – your therapist will ask you questions in order to challenge your current beliefs. This can allow you to think of situations in a whole new light.
- Exposure therapy – this technique is used for you to face your fears. Your therapist will slowly expose you to things that provoke your anxiety, all the while teaching you how to cope with them.
- Journaling – writing is a tried-and-true method of getting in touch with your thoughts. You’ll keep track of your new thoughts and behaviors. Writing all this down also allows you to track your progress as you work through your anxiety.
- Activity scheduling and behavior activation – if you avoid a certain activity, this is the time to put it on your calendar and schedule a time to do it. Scheduling these activities allows you to practice what you’ve learned.
- Behavior experiments – These are typically used for anxiety disorders involving catastrophic thinking or imagining the worst-case scenario. Before you begin an activity that makes you anxious, your therapist will ask you what you think will happen. Later, you’ll talk about whether your prediction came true or whether your projections were all in your negative thinking pattern.
- Relaxation and stress reduction – you will learn ways in which you can lower your stress levels and gain a sense of self-control. This is especially helpful for those with social anxiety disorder.
- Role-playing – This technique will allow you and your therapist to work through potentially stressful or harmful behaviors. Playing out the scenario can help you lessen your fears, gain perspective, practice social skills, and improve your communication skills.
- Successive approximation – this involves taking a look at your negative behavior and breaking them down into smaller, more attainable steps. Each successive step builds on the next. These consecutive “wins” can build your confidence as you progress.
Continuing education for professionals
CBT is not just for those with anxiety disorders. The Feeling Good Institute (FGI) is recognized by the American Psychological Association and other therapy associations to provide mental health professionals such as psychiatrists, psychologists, social workers, and counselors training for cognitive-behavioral therapy. In addition to training the Feeling Good Institute also offers CBT courses and certification.
What would therapy certification entail?
For mental wellness professionals, the Feeling Good Institute offers TEAM-CBT certification. TEAM is an acronym for the four essential components of effective therapy known to improve treatment outcomes: Testing (or measurement), Empathy, Assessment of Resistance, and Methods (more than 50 cognitive and behavioral methods!).
Considered one of the forefathers of CBT, Dr. David Burns is a prominent psychiatrist who created the framework for doing therapy: TEAM-CBT. Dr. Burns is also a best-selling author. His books include: When Panic Attacks, Feeling Good: The New Mood Therapy, and Feeling Great: The Revolutionary New Treatment for Depression and Anxiety.
TEAM-CBT therapy certification is offered in five levels from beginner to expert level allowing you to see your results while you build your expertise. Therapists learn by didactic presentation, discussion, deliberate practice exercises, and specific feedback. Unlike other therapy certification programs that are more theory-based, TEAM-CBT teaches you hands-on practical tools you can utilize in the field to make your therapy more effective.
For mental health professionals interested in training for cognitive-behavioral therapy and certification, the Feeling Good Institute organizes, trains, and supports the more than 1,000 therapists who successfully practice TEAM-CBT. We can give you the tools you need for a more effective practice.
If you are experiencing anxiety and want to learn the skills you need to break your negative thought patterns, the Feeling Good Institute is here for you with online sessions or in-person treatment. We can match you with one of our highly-qualified therapists so you can take that first step to live a happier, healthier life.
Please contact us at https://www.feelinggoodinstitute.com.
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