Cognitive Behavioural Therapy (CBT) is the psychotherapy with the best evidence base and therefore is the first-line psychotherapy for treating anxiety disorders. Depending on individual response to CBT, the severity and complexity of any comorbid condition and the presence of a personality disorder, other types of psychotherapy may be indicated. Patient choice and motivation are important factors in the success of any therapy for anxiety disorders. Patients who choose CBT generally do better than those who are assigned to it without choice. CBT should involve an adequate treatment trial with appropriate monitoring and follow-up. CBT is effective in both individual and group formats. Overall, it can be as effective as pharmacotherapy.
There is no evidence that routinely combining medication and CBT is more effective than either treatment alone; however, if it is available, CBT should be encouraged, even alongside pharmacotherapy.
Progress is monitored session by session in CBT, and if the patient’s condition does not improve sufficiently, therapy can be modified to fit the patient’s needs, rather than switching to another type of psychotherapy. The duration and frequency of CBT sessions is important. Ideally, CBT should involve two sessions a week of 60 or 90 minutes. Twelve to 20 sessions, depending on the specific disorder, will usually be sufficient to produce a therapeutic effect. Follow-up sessions every month are useful in maintaining gains, and can be held as self-help community-based groups.
- The Primary Care Practitioner Role
- Screening & Assessment
- Clinical Tools
- Resources & References