October 23, 2018
Dr. Luana Marques is the director and founder of Community Psychiatry PRIDE at Massachusetts General Hospital and an Associate Professor in Psychology at Harvard Medical School. She completed her PhD in Clinical Psychology at The State … See Full Bio
Dr. Soo Jeong Youn is the Director of Evaluation at Community Psychiatry Program for Research in Implementation and Dissemination of Evidence-Based Treatments (PRIDE) at Massachusetts General Hospital (MGH), and an Assistant Professor in Psychology in the … See Full Bio
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CBT FOR ANXIETY – HOW LONG WILL IT TAKE?
Does CBT work for anxiety?
When you suffer from anxiety, it is natural for you to want to feel better as soon as possible. Many people seek cognitive behavioural therapy (CBT) as their treatment of choice for anxiety issues. This is because evidence-based research demonstrates that CBT for anxiety can be a highly effective treatment; in fact GPs often recommend it. But how long will the treatment take? It’s a question that many people ask when considering treatment.
How long does CBT take – factors affecting length of treatment
According to the government’s mental health recommendations (NICE), 6 to 24 sessions are recommended for effective treatment. There are some common factors that influence the number of sessions you are likely to need to achieve a successful outcome, using CBT for anxiety. However, since every individual is unique, there are bound to be variances. Someone with severe anxiety may find they feel better quicker than expected, while someone with mild anxiety may find they need more support, due to other influencing factors.
Anxiety severity
Anxiety severity, then, is the most common factor determining the number of cognitive behavioural therapy sessions you are likely to need. Anxiety severity is generally categorised into 3 types:
Mild Anxiety: This occurs when bouts of anxiety arise in response to specific situations, for short periods of time. The feelings of anxiety are uncomfortable but manageable, and they may or may not be accompanied by panic attacks. The anxiety does not prevent the sufferer from carrying out day-to-day activities but it might cause them to avoid certain situations, in an attempt to stop anxiety from occurring.
Moderate Anxiety: This is when bouts of anxiety occur more frequently in day-to-day life and panic attacks may be present. Anxiety can be brought on by specific trigger situations. Sufferers can also experience a underlying feeling of general anxiety that doesn’t seem to be attached to anything specific but hangs around for several hours or longer. Sufferers can still manage day-to-day life, however their anxiety can interfere in a more problematic way, causing the individual to avoid certain situations or issues that they should really deal with.
Severe Anxiety: This is when anxiety presents on a daily basis, often with panic attacks. Sufferers can find it extremely difficult to manage their day-to-day life. Severe anxiety can prevent them from engaging in important tasks and, in worst case scenarios, it can prevent them from working, enjoying healthy relationships, engaging socially and leading a normal life.
Additional factors
Other factors that may affect the length of treatment needed include
- The length of time that you have been experiencing anxiety
- The degree of change that you are hoping to achieve
- The extent to which CBT therapy matches your personal learning style
- The question whether CBT therapy alone can help you achieve lasting change
- Your life situation
- Your level of self confidence
How long does CBT take to treat mild anxiety?
3 to 12 sessions may be sufficient to treat a presentation of mild anxiety. CBT therapy alone can help you gain an understanding of your anxiety and identify some effective strategies to deal with it. At KlearMinds, our sessions for individuals last 50 minutes. Meetings usually take place weekly, at the same time on the same day since this format has proved most effective.
How long does CBT take to treat moderate anxiety?
6 or 12 to 24 sessions of CBT therapy may be enough to successfully treat a presentation of moderate anxiety. Some people may need a bit longer, for instance where symptoms have been contained in the background for some years prior to treatment. When treating moderate anxiety, CBT therapy can sometimes be limited in its ability to help sufferers understand and address underlying root causes of anxiety. If root causes are addressed, this can help people better understand background issues that trigger their anxiety. It can also enable them to feel better equipped to deal with any “unexpected anxiety” that may occur in the future.
How long does CBT take to treat severe anxiety?
A minimum of 24 sessions of CBT therapy may be needed to treat a presentation of severe anxiety. Some individuals may recover more quickly, while others may require 48 or more CBT sessions combined with additional therapies to ensure that underlying root causes of anxiety are tackled. Because root causes are always an influencing factor in maintaining severe anxiety, the best outcomes can be achieved if the therapy addresses them. By integrating other psychotherapy approaches alongside CBT, it can be possible to achieve more effective and lasting change.
To learn more about the range of therapies we provide at KlearMinds to help when CBT therapy alone may not be enough, click here.
FURTHER INFORMATION ON ANXIETY AND CBT THERAPY
How Cognitive Behavioural Therapy Can Help Treat Anxiety Disorders
CBT for Social Anxiety
Panic Attacks: How Can Cognitive Behavioural Therapy Help?
CBT for Panic Attacks
Ten Tips For Managing Panic Attacks
Is Cognitive Behavioural Therapy More Effective Than Medication in Treating Anxiety?
CBT for Stress
Anxiety In The UK – Infographic
Anxiety Management
How Can Cognitive Behavioural Therapy Help to Treat Depression?
CBT for Low Self Esteem
CBT for Anger Management
Cognitive Behavioural Therapy (CBT) in London
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Cognitive behavioral therapy (CBT) is a type of psychotherapy. This form of therapy modifies thought patterns to help change moods and behaviors.
It’s based on the idea that negative actions or feelings are the results of current distorted beliefs or thoughts, not unconscious forces from the past.
CBT is a blend of cognitive therapy and behavioral therapy. Cognitive therapy focuses on your moods and thoughts. Behavioral therapy specifically targets actions and behaviors.
A therapist practicing the combined approach of CBT works with you in an agreed-upon location, offering guidance and direction. You and your therapist may work to identify specific negative thought patterns and behavioral responses to challenging or stressful situations.
This type of therapy is commonly used for a wide range of mental health challenges and diagnoses, including:
- depression
- anxiety
- eating disorders
- post-traumatic stress disorder (PTSD)
- insomnia
- obsessive-compulsive disorder (OCD)
- bipolar disorder
- phobias
- chronic pain
- panic attacks
Treatment typically involves developing more balanced and constructive ways to respond to stressors. Ideally, these new responses will help you cope with or recover from challenging mental health conditions or unwanted behaviors.
The principles of CBT can be applied outside of the therapist’s office, providing you with coping tools to help you through life’s challenges. CBT teaches you to become aware of and adjust negative patterns, which can help you reframe your thinking during moments of heightened anxiety or panic.
It can also provide new coping skills, like meditation or journaling, for those struggling with a substance use disorder or depression.
How does CBT work?
CBT is a more short-term approach than psychoanalysis and psychodynamic therapies. Other types of therapies may require several years for discovery and treatment.
CBT often requires only up to 20 sessions, according to the National Health Services, but you can continue seeing your therapist for as long as you need. Every situation is unique, so how long you pursue treatment is up to you and your therapist.
CBT sessions provide opportunities to identify current life situations that may be causing or contributing to your mental health conditions, like anxiety or depression. CBT allows you and your therapist to identify patterns of thinking or distorted perceptions that are no longer serving you.
This is different from psychoanalysis. This type of therapy involves working backward through your life history to discover an unconscious source of the problems you’re facing.
You may be asked to keep a journal as part of CBT. The journal provides a place for you to record life events and your reactions. Your therapist can help you break down reactions and thought patterns into several categories of self-defeating thought (also known as cognitive distortions).
These may include:
- all-or-nothing thinking: viewing the world in absolute, black-and-white terms
- disqualifying the positive: rejecting positive experiences by insisting they “don’t count” for some reason
- automatic negative reactions: having habitual, scolding thoughts
- magnifying or minimizing the importance of an event: making a bigger deal about a specific event or moment
- overgeneralization: drawing overly broad conclusions from a single event
- personalization: taking things too personally or feeling actions are specifically directed at you
- mental filter: picking out a single negative detail and dwelling on it exclusively so that the vision of reality becomes darkened
You and your therapist can also use the journal to help replace negative thought patterns or perceptions with more constructive ones. This can be done through a series of well-practiced techniques, such as:
- learning to manage and modify distorted thoughts and reactions
- learning to accurately and comprehensively assess external situations and reactions or emotional behavior
- practicing self-talk that is accurate and balanced
- using self-evaluation to reflect and respond appropriately
You can practice these coping methods on your own or with your therapist. Alternately, you can practice them in controlled settings in which you’re confronted with challenges. You can use these settings to build on your ability to respond successfully.
How can CBT help with depression?
If you’re someone who struggles with depression, your therapist may use CBT techniques to help you uncover unhealthy patterns of thought and identify how they may be affecting:
- your mood
- beliefs about yourself
- your overall outlook on life
You may also be assigned “homework” so that you can practice replacing negative thoughts with more positive thoughts in real time.
How well does CBT work for depression?
CBT has been proven to be effective in treating mild to moderate levels of depression. In some cases, it can be combined with other treatments, like antidepressants or other medications, to treat depression.
What other conditions can CBT treat?
Cognitive behavioral therapy is widely used to treat an array of mental health conditions in children, adolescents, and adults. These may include:
- antisocial behaviors (including lying, stealing, and hurting animals or other people)
- anxiety
- attention deficit hyperactivity disorder
- bipolar disorder
- conduct disorder
- depression
- eating disorders such as binge eating, anorexia, and bulimia
- general stress
- personality disorders
- phobias
- schizophrenia
- sexual disorders
- insomnia
- social skill problems
- substance use disorder
In certain cases, cognitive behavioral therapy may be combined with other treatments to help with depression.
Are there any risks?
There is little long-term emotional risk associated with CBT. But exploring painful feelings and experiences can be stressful. Treatment may involve facing situations you’d otherwise avoid.
For instance, you may be asked to spend time in public places if you have a fear of crowds. Alternately, you may need to confront difficult sources of trauma, like the death of a loved one.
These scenarios can provide opportunities to practice altered responses to stressful or adverse situations. The eventual goal of therapy is to teach you how to deal with anxiety and stress in a safe and constructive manner.
What experts say
“There is a massive tidal wave of evidence for cognitive behavioral therapy that suggests it is very effective at treating certain problems,” Simon Rego, PsyD of Montefiore Medical Center in New York, told Healthline. “The breadth of evidence isn’t as extensive for other forms of psychotherapy.”
That’s not to say other therapies aren’t equally effective and beneficial. “They just don’t fit as neatly into anything that can be studied,” Rego says. “More evidence-based studies have been conducted on the results of cognitive behavioral therapy than any other kind.”
Online therapy for CBT
If you feel that you or a loved one could benefit from CBT, there are several telehealth platforms that can virtually connect you with a trained therapist. Here are some to consider:
- TalkSpace. After taking an initial assessment and choosing your subscription plan, you’ll be connected with someone from their network of over 3,000 licensed therapists.
- BetterHelp. This telehealth company has one of the largest networks of licensed therapists and offers individual, couples, and family counseling.
- Amwell. Along with talk therapy, Amwell can also connect you with online psychiatrists who can prescribe medications.
- 7 Cups. This telehealth network is significantly less expensive than other online therapy platforms. Plus, 7 Cups offers emotional support and access to speak to a trained volunteer (not a licensed counselor) at no charge.
FAQs
How can I find a CBT therapist?
If you think CBT may be a fit for you, there are several ways to find a therapist.
You can:
- talk with your doctor
- search the directory of certified therapists
- reach out to an online therapy program
- contact your health insurance company to see if your plan covers therapy visits
What can I expect from CBT?
Your CBT experience will be unique based on your situation but know that there is no right or wrong way to experience therapy.
Your therapist will take time to get to know you, so be prepared to discuss:
- what brought you to therapy
- your mental health history
- current circumstances
Will CBT help my depression?
CBT has been found to be effective in treating those with mild to moderate depression. It has also been proven effective when combined with other treatment options, like antidepressants or other medications.
Remember that change is often gradual, requiring a time commitment and the willingness to be open to the experience.
Takeaway
Cognitive behavioral therapy (CBT) is a type of psychotherapy that helps you recognize and replace negative or unhelpful thought and behavior patterns. It can be a highly rewarding and effective form of mental health support for those affected by anxiety, depression, OCD, insomnia, substance use disorder, and more.
CBT requires a willingness to be open to change, along with a time commitment to do the work with your trusted therapist.
The goal of CBT is to help you develop the skills to help deal with difficulties on your own, at the moment when they come up, ideally giving you tools that last a lifetime.
