Cognitive behavioral therapy (CBT) is probably the most well-known and most-practiced form of modern psychotherapy. Even therapists who don’t identify themselves as a CBT therapist likely uses at least a handful of CBT techniques in their practice. And while much of CBT’s popularity is centered around its use for depression and related mood disorders, it’s also useful for many other disorders, including anxiety.
But to-date, there has been no systematic review of the efficacy of cognitive-behavioral therapy in randomized placebo-controlled research trials for anxiety. Until now.
In April, researchers from Boston University conducted an extensive literature review on CBT studies that reviewed the efficacy of CBT versus a placebo for anxiety disorders. Out of an original 1,165 studies identified, they found 27 that met their inclusion criteria.
They found support for the use of CBT in anxiety disorders. Specifically, the severity of anxiety symptoms was decreased for people who took CBT over placebo, and the effect of this decrease was most significant for people with obsessive-compulsive disorder and acute stress disorder. The smallest effect size the researchers found was for the use of CBT in panic disorder.
The researchers also noted that while they did find CBT effective for many anxiety disorders, there is considerable room for improvement for future research in this area. CBT is not a cure-all, but when wielded by an experienced therapist, it can provide helpful, beneficial results for most people suffering from an anxiety disorder.
Reference
Hofmann SG & Smits JA. (2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry, 69(4), 621-32.
(11 votes, average: 4.55 out of 5)
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10 Responses to “How Effective is Cognitive Behavioral Therapy (CBT) for Anxiety?” (Pingbacks/trackbacks not shown below)
kim_johnson at 10:51 am on
June 28th, 2008
I’m a little confused about this lack of research. I thought that the efficacy of behaviorist interventions such as flooding and systematic desensitization were well documented by the behaviorists back in the 60’s. Both with respect to how phobia can be conditioned, and with respect to how phobic responses can be extinguished. Little Albert springs to mind - I think there was a search for him at some point so they could treat his phobia - but he never was found. I thought that cognitive behavior therapy basically inherited those behaviorist techniques…
kim_johnson at 10:55 am on
June 28th, 2008
Ah. Sorry - I misunderstood. A REVIEW study on double blind control trials…
Wendy Aron at 3:50 pm on
June 28th, 2008
I am living proof that CBT works. I have been with the same cognitive behavioral therapist for over ten years and my depression/anxiety has abated. In fact, I have not had any hospitalizations since seeing her. Of course, I am also on medication, which is another part of the puzzle. But I can say that without a doubt, the therapy is an equally important component of my treatment.
Wendy Aron, author of Hide & Seek: How I Laughed at Depression, Conquered My Fears and Found Happiness
Was the comorbidity of depression and anxiety disorders taken into account? It might the case that CBT only works for anxiety when it co-occurs with depression..
How great to see a confirmation of something we have witnessed in counseling offices for years. But before counseling for anxiety, a therapist needs to establish a diagnosis.
Check out QPASSLive.com for a new assessment tool that measures anxiety, anger and depression in one test in about 10 minutes for only $.69 per use. Psychometrics and more information is all there.
kim_johnson at 10:41 am on
July 2nd, 2008
Was the QPASSLive.com assessment tool the tool that was used to screen for whether people had anxiety / depression in the study that was conducted here? If not then… Er… How is it relevant?
Hell, I’ll give you a diagnosis if you mail me 40 bucks 
kim_johnson at 10:46 am on
July 2nd, 2008
While one persons experience is interesting when one is attempting to provide the treatment that is most effective for a certain RANGE of people then ones personal experience is only one among many.
Similarly, when one is delivering a certain variety of therapy when one is attempting to assess the efficacy of different varieties of treatment it is important to note that ones own variety of therapy is only one among many.
So… It is nice that studies are being done. While a particular individual might say ‘I know that was what was true for me all along’ and while a theorist of a certain theoretical orientation might say ‘that is what I’ve clinically observed all along’ such things as confirmation bias mean that control trials trump anecdotal reports. The evidence really could have gone either way, you see…
Carol H at 5:10 pm on
July 9th, 2008
I’ve been the cognitive-behavioural therapy (Beck System) and it worked some of the time, but not all of the time. I was given worksheets but hit a brick wall. There were approximately six/seven different columns and I could never get past the one where it said, to write down a reason why I shouldn’t react. At the time, I was going through major emotional and psychological hell with my late IL. She couldn’t stand me and basically controlled my spouse and me and she was the reason I decided to get involved with counselling with my former doctor who left her GP practice to become a psychotherapist.
Where I live, there aren’t any psychologists or psychiatrists.
I do a lot of internet self-help research and have created a binder of ideas of how to get along with people, among multiple other suggestions and ideas.
I’ve been through multiple anti-depressant medications as well as Ativan for anxiety which on the rare occasion, I find it necessary to take.
Betty L. at 9:48 am on
October 22nd, 2008
I tried CBT this summer for panic attacks and I was panic attack free after just 12 sessions! In the past I had tried psychoanalysis, medication and “behavioral therapy” (i use quotes because this person was more of a life coach, she helped me organize my life, but did next to nothing to directly address my anxiety), nothing helped me like Cognitive Behavioral Therapy. It was really amazing. I only wish I could have done it sooner in life. However, like anything else, I think it’s important to find a good, well-trained cognitive behavioral therapist. I had tried cbt books on my own, but it wasn’t the same as going to talk to a cognitive behavioral therapist in person. What’s more, I went to a reserach center where they only practice cbt and have the latest research on anxiety disorders.
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I’m a little confused about this lack of research. I thought that the efficacy of behaviorist interventions such as flooding and systematic desensitization were well documented by the behaviorists back in the 60’s. Both with respect to how phobia can be conditioned, and with respect to how phobic responses can be extinguished. Little Albert springs to mind - I think there was a search for him at some point so they could treat his phobia - but he never was found. I thought that cognitive behavior therapy basically inherited those behaviorist techniques…
Ah. Sorry - I misunderstood. A REVIEW study on double blind control trials…
I am living proof that CBT works. I have been with the same cognitive behavioral therapist for over ten years and my depression/anxiety has abated. In fact, I have not had any hospitalizations since seeing her. Of course, I am also on medication, which is another part of the puzzle. But I can say that without a doubt, the therapy is an equally important component of my treatment.
Wendy Aron, author of Hide & Seek: How I Laughed at Depression, Conquered My Fears and Found Happiness
Was the comorbidity of depression and anxiety disorders taken into account? It might the case that CBT only works for anxiety when it co-occurs with depression..
How great to see a confirmation of something we have witnessed in counseling offices for years. But before counseling for anxiety, a therapist needs to establish a diagnosis.
Check out QPASSLive.com for a new assessment tool that measures anxiety, anger and depression in one test in about 10 minutes for only $.69 per use. Psychometrics and more information is all there.
Was the QPASSLive.com assessment tool the tool that was used to screen for whether people had anxiety / depression in the study that was conducted here? If not then… Er… How is it relevant?
Hell, I’ll give you a diagnosis if you mail me 40 bucks
While one persons experience is interesting when one is attempting to provide the treatment that is most effective for a certain RANGE of people then ones personal experience is only one among many.
Similarly, when one is delivering a certain variety of therapy when one is attempting to assess the efficacy of different varieties of treatment it is important to note that ones own variety of therapy is only one among many.
So… It is nice that studies are being done. While a particular individual might say ‘I know that was what was true for me all along’ and while a theorist of a certain theoretical orientation might say ‘that is what I’ve clinically observed all along’ such things as confirmation bias mean that control trials trump anecdotal reports. The evidence really could have gone either way, you see…
I’ve been the cognitive-behavioural therapy (Beck System) and it worked some of the time, but not all of the time. I was given worksheets but hit a brick wall. There were approximately six/seven different columns and I could never get past the one where it said, to write down a reason why I shouldn’t react. At the time, I was going through major emotional and psychological hell with my late IL. She couldn’t stand me and basically controlled my spouse and me and she was the reason I decided to get involved with counselling with my former doctor who left her GP practice to become a psychotherapist.
Where I live, there aren’t any psychologists or psychiatrists.
I do a lot of internet self-help research and have created a binder of ideas of how to get along with people, among multiple other suggestions and ideas.
I’ve been through multiple anti-depressant medications as well as Ativan for anxiety which on the rare occasion, I find it necessary to take.
I tried CBT this summer for panic attacks and I was panic attack free after just 12 sessions! In the past I had tried psychoanalysis, medication and “behavioral therapy” (i use quotes because this person was more of a life coach, she helped me organize my life, but did next to nothing to directly address my anxiety), nothing helped me like Cognitive Behavioral Therapy. It was really amazing. I only wish I could have done it sooner in life. However, like anything else, I think it’s important to find a good, well-trained cognitive behavioral therapist. I had tried cbt books on my own, but it wasn’t the same as going to talk to a cognitive behavioral therapist in person. What’s more, I went to a reserach center where they only practice cbt and have the latest research on anxiety disorders.
