CBT for Anxiety: What It Is and How It Works

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Feeling anxious can feel overwhelming and it might make it difficult for you to enjoy life fully. You may notice that work, your health, and even relationships, begin to suffer when anxiety starts to take control. However, I’ve come to realize through my training in Cognitive Behavioral Therapy (CBT), and working with my clients over the past 25 + years, that CBT stands out as a very effective treatment to manage anxiety and worry.

CBT is a type of therapy that empowers people to get unstuck quickly. It focuses on recognizing and altering automatic negative thought patterns and unhelpful behaviors that fuel anxiety. Unlike other therapies, CBT is usually short-term and goal-oriented, making it particularly appealing for people eager to see progress in managing their anxiety.

I find that Cognitive Behavioral Therapy (CBT) is a very effective anxiety treatment and it’s success has been proven by many research studies. It is not the only psychological framework I utilize; we can also identify how your past experiences, and possible trauma, affect you now and explore relationships difficulties and long term stressors. But when you are in the midst of life transitions, have a lot of current stress and feel out of control of events around you, or if you are a worrier and overthink things, utilizing CBT strategies is a great place to start anxiety counseling.

Cognitive therapy CBT helps anxiety

What Anxiety Disorders Can CBT Treat?

Understanding the specific anxiety disorders that Cognitive Behavioral Therapy (CBT) can effectively treat is crucial, and it helps tailor my approach to your unique experiences. Here are some anxiety disorders that CBT can address:

1. Generalized Anxiety Disorder (GAD):  

GAD is characterized by persistent and excessive worry about various aspects of daily life, such as health, work, and personal relationships. This type of anxiety often feels uncontrollable and is accompanied by physical symptoms like restlessness, fatigue, and muscle tension.

2. Social Anxiety Disorder:  

Social anxiety, also known as social phobia, involves intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. It can lead to avoidance of social interactions, impacting daily activities and relationships.

3. Panic Disorder:  

Panic disorder is characterized by recurrent, unexpected panic attacks — sudden periods of intense fear that may include palpitations, sweating, trembling, and feelings of impending doom. Individuals often worry about additional attacks and change their behavior to avoid them.

4. Health Anxiety:  

Health anxiety involves excessive worry about having a serious illness, often triggered by normal bodily sensations. This can lead to frequent visits to healthcare providers for reassurance, which only temporarily alleviates the anxiety.

5. Specific Phobias:  

Specific phobias are intense, irrational fears of specific objects or situations. The fear experienced is disproportionate to the actual danger posed, leading to avoidance behavior.

6. Post-Traumatic Stress Disorder (PTSD):  

PTSD can develop after experiencing or witnessing a traumatic event. It is marked by intrusive memories, avoidance of reminders, negative changes in thoughts and mood, and hyperarousal symptoms such as irritability and sleeping issues.

7. Obsessive-Compulsive Disorder (OCD):  

OCD involves unwanted and intrusive thoughts (obsessions) that lead to repetitive behaviors or mental acts (compulsions) performed to reduce anxiety. This disorder can consume significant amounts of time and interfere with daily functioning.

8. Other Anxiety-Related Disorders:  

CBT is also effective for other conditions where anxiety plays a significant role, such as Adjustment Disorder with Anxiety, where stress is related to a specific event or situation.

What Is CBT for Anxiety and How It Works

Cognitive Behavioral Therapy (CBT) has emerged as a popular method for treating anxiety, and I’ve witnessed its positive impact firsthand. By combining cognitive and behavioral techniques, CBT helps you understand and shift your thought patterns.

Cognitive Behavioral Therapy (CBT) focuses on three key areas—cognitive restructuring, emotional regulation, and behavior change.

Cognitive Restructuring

Cognitive restructuring teaches you how to catch the emotion and then identify and challenge automatic unhelpful thoughts replacing them with more balanced and constructive alternatives.

Automatic Negative Thoughts And Anxiety

Anxiety often stems from negative thought patterns. These unhelpful thoughts are linked to strong negative emotions such as worry, sadness, anger and frustration and feelings of being overwhelmed or panicky. These types of thoughts are usually so automatic that we don’t even know we are thinking them, we just feel the emotion.

For example, if you feel overwhelmed and worried about an upcoming work presentation and think, “I can’t handle this,” or “People will ask me questions and I won’t be able to answer them and I’ll look foolish”, cognitive restructuring would involve questioning the accuracy of those thoughts. I would ask you to bring to mind a time when have you handled a similar thing in the past. We could look to your personal history and then replace the negative thought with something more supportive like, “I’ve handled presentations and difficult situations before, and I can do it again.” Similarly, you could re-frame it into “I can take this one step at a time. I will prepare for the presentation and if I don’t know the answer to a question I will take a breath and tell them that I will get back to them with that answer”. This shift in perspective alone can ease emotional tension and provide a sense of control.

CBT and Our Core Values

Cognitive Behavioral Therapy can also be a powerful tool in aligning your daily life with your core values. Often, we feel stuck or disconnected because our thoughts and actions don’t match what truly matters to us—things like relationships, creativity, or personal growth. Through CBT, we can gently uncover patterns of unhelpful thinking or behaviors that might be steering you away from your core values and take steps towards how you want your life to be.

The first step to any change is to recognize what we say to ourselves that holds us back. Part of our counseling session will typically focus on talking about your worries, identifying unhelpful thinking patterns and behaviors that you do automatically and learning different strategies. If you would like to practice these skills outside of the sessions it can strengthen your skills and provide real life situations to see if they work. 

Common Thought Traps

The next step in cognitive restructuring is to notice if our automatic negative thoughts fall into common thought traps, which can also be called thought distortions. Once you’ve identified these traps, remind yourself that just because you think something doesn’t mean it’s true. Your thoughts are not facts. Challenge them and replace them with more realistic, helpful thoughts. For example, “Just because I didn’t do this perfectly doesn’t mean I failed—it’s still progress”.

Here are the most common thought traps to watch for:

1. All-or-Nothing Thinking  

   – Distortion: “If I fail this test, I’m a complete failure.”

   – Intervention: Challenge it with, “One test doesn’t define me. I’ve done well before and can again.”

2. Catastrophizing  

   – Distortion: “If I make a mistake at work, I’ll get fired.”

   – Intervention: Counter with, “Mistakes happen. I can learn and improve.”

3. Overgeneralization  

   – Distortion: “I didn’t do well in this project, so I’ll never succeed.”

   – Intervention: Re-frame it as, “One project doesn’t determine my future. I can do better next time.”

4. Mental Filtering  

   – Distortion: “I only got one compliment, so my presentation wasn’t good.”

   – Intervention: Consider, “One compliment means someone appreciated my work. I should value positive feedback.”

5. Mind-Reading 

  – Distortion: “My partner should know I’m upset without me having to say anything.”

   – Intervention: Adjust it to, “I will tell him what I feeling and why and that allows him to tell me how he feels and we can work together to come up with a solution.”

Emotional Regulation

CBT for Anxiety

Emotional regulation is a crucial skill in CBT. By practicing techniques like deep breathing, mindfulness, and relaxation exercises, you can reduce the intensity of anxiety and feel more in control. When you worry or get anxious or stressed, your body gets flooded with adrenaline.

Breathing and grounding techniques can help you calm down during moments of acute anxiety. These techniques effectively reduce adrenaline and slow down racing thoughts which is an important first step before trying to think about things differently. Employing mindfulness and relaxation techniques regularly can make you feel more calm overall.

To learn more about these techniques and the brain science behind them, check out these helpful resources:

Changing Behavior Can Change Anxiety

CBT also focuses on changing behaviors that contribute to anxiety. It encourages you to challenge your fears and gradually confront situations that might feel overwhelming. Here are a few of the techniques we may use:

Exposure to Avoided Situations: Gradual exposure to feared or avoided situations helps reduce the power they have over an individual. Starting with less threatening scenarios and slowly working up to more challenging ones helps build tolerance and reduce avoidance behaviors, ultimately lessening anxiety.

Behavioral Activation. This involves actively increasing your engagement in meaningful activities, even if you don’t feel motivated initially. When anxiety sets in, it’s common to withdraw from people and activities. Unfortunately, this withdrawal often intensifies negative feelings. By gently pushing yourself to participate in activities aligned with your personal values, you can cultivate positive emotions and a sense of achievement.

Start small—with goals that feel manageable and attainable. Maybe it’s as simple as taking a walk, calling a friend, or doing a hobby you enjoy. These intentional steps can help boost your mood and motivation over time. The key is to focus on activities that are meaningful to you and resonate with your values.

Thought Stopping: This involves using a mental or verbal cue, such as the word “stop,” to interrupt negative and intrusive thoughts, followed by substituting them with more constructive ones. This technique helps in breaking the cycle of rumination.

Problem Solving: Anxiety often makes problems appear overwhelming. This approach involves breaking problems into smaller, more manageable parts and brainstorming potential solutions. Taking systematic steps towards solving these smaller issues can reduce feelings of helplessness and anxiety.

Psychoeducation: Understanding the nature of anxiety and how it affects the body and mind is empowering. Gaining knowledge about anxiety disorders can demystify symptoms, reduce stigma, and make the application of coping strategies more effective and personalized.

How Homework Can You Manage Anxiety Outside of Therapy Sessions

Part of our counseling session will typically focus on identifying unhelpful thinking patterns and behaviors, recognizing thought traps and learning different strategies. If you would like to practice these skills outside of the sessions it can strengthen your skills and provide real life situations to see if they work. Or if you find they don’t work, you can note what happens, we can talk it though to find the stumbling blocks and revise the strategies or find new ones. I have been treating anxiety for almost 3 decades and I have a lot of knowledge about clinical practice and research but YOU are the expert about yourself and your life. Together we work together to find what works best for you!

Homework can provide the following benefits:

Creates Awareness of Thought Patterns

Journaling: Keeping a journal helps in tracking progress over time and identifying recurring themes or worries that might need addressing. The first step involves identifying unhelpful negative thoughts. We often operate on autopilot when it comes to our thoughts and behaviors. Homework helps you slow down and notice the patterns that may be contributing to your challenges.

By journaling or using thought records, you may start identifying triggers for anxiety or discovering unhelpful, recurring beliefs such as “I’m not good enough”. Increased awareness is the first step toward meaningful change. Pay attention to your internal dialogue. Write down the thoughts or self-talk that make you feel anxious. How do these thoughts make you feel, and how do they influence your behavior? Writing can also be a cathartic exercise, helping you process emotions, reflect on experiences, and gain insight into your thought processes.

CBT Anxiety

Pattern Tracking: This involves keeping a diary or log of anxiety episodes to spot patterns over time. By noting when and where anxiety spikes occur, as well as the thoughts and situations surrounding them, you can begin to understand and manage their triggers more effectively.

Bridges the Gap Between Sessions

One of the challenges in therapy is maintaining momentum between sessions. Homework keeps the work going on your own time. Instead of waiting to explore insights until your next appointment, you can reflect, process, and practice in the days between sessions.

Builds Confidence

The ultimate goal of therapy is not just to feel better but to equip you with the tools to manage on your own. Homework accelerates this process by giving you real-life opportunities to see what works—and what doesn’t. Each time you complete a task, you’re building confidence in your ability to handle situations, re-frame negative thoughts, or break unhelpful habits. Remember, retraining your mind takes practice and patience. You don’t have to believe every anxious thought that arises. With time, you’ll develop new, healthier ways of thinking that bring clarity and calm.

Other Tools To Use Between Sessions

Physical activity is another powerful tool. I often recommend regular exercise, not necessarily for its physical benefits alone, but because it significantly impacts our mental well-being. Whether it’s a walk or yoga, integrating some form of movement into your routine can help reduce tension and anxiety. Moving physically can also disrupt rumination. If your thoughts are going around and around in your head as you are sitting or lying down, getting up and moving is a good outlet for adrenaline your thoughts are causing.

Simple actions like ensuring you get enough sleep, eating regularly to keep your blood sugars even and being mindful of your caffeine and alcohol intake can also make a difference. These lifestyle factors might seem small, but clients frequently report feeling a clearer mind and more stable moods when they attend to these basics. I’ve observed that managing time effectively also plays a role in reducing anxiety. Breaking tasks into smaller, manageable steps and prioritizing them can prevent feelings that overwhelm.

Lastly, don’t underestimate the value of social connections. Building your social connections or talking with your current supportive friends or family can provide a necessary emotional buffer against anxiety. If you experience anxiety in social situations or difficulties with your relationships, we can also address that during sessions.

How Is CBT for Anxiety Different From Other Forms of Therapy?

CBT’s distinctiveness lies in several aspects, which I’ve come to value greatly. Firstly, it is typically a short-term, goal-directed therapy. While other therapies may extend over years, CBT often spans 12 to 20 sessions, making it a focused and efficient option for many people.

Importantly, CBT emphasizes the present. Unlike some therapies that explore past experiences in-depth, CBT focuses in on current thoughts and behaviors. I’ve found this approach is empowering; it enables clients to make immediate changes, enhancing mental health right away. It’s a straightforward method to manage anxiety and enhance life quality.

I find that Cognitive Behavioral Therapy (CBT) is a very effective anxiety treatment and it’s success has been proven by many studies. It is not the only psychological framework I utilize; we can also explore how your relationships, work challenges, health conditions and past experiences such as trauma affect you, but utilizing CBT strategies is a great place to start anxiety counseling. It’s not that one technique is better than another; rather, it’s about finding what truly resonates with your needs and circumstances.

In all my sessions, I aim to provide a supportive environment where you can explore and grow. There’s no one-size-fits-all, and my approach is adaptable, based on what best supports you on your path to managing anxiety.

For a more general article about all the issues CBT treats read What Is CBT? A Simple Guide to Understanding Cognitive Behavioral Therapy

How Effective Is CBT for Anxiety?

From both personal observations and numerous studies, CBT is effective in treating anxiety. Research consistently shows substantial symptom reduction across various anxiety disorders for those engaging in CBT.

One study highlighted CBT’s superiority over medication alone for treating anxiety. Clients completing CBT exhibited lower relapse rates than those relying solely on medication, making it a preferred choice for many.

Moreover, CBT equips you with long-lasting skills. These skills empower you to manage anxiety even after therapy concludes. The practical strategies acquired during CBT support coping with future anxiety episodes independently.

The consistent positive outcomes from CBT underscore its value in treating anxiety disorders. It offers a structured, evidence-based approach to managing and alleviating anxiety.

Conclusion

Cognitive Behavioral Therapy (CBT) is an outstanding method to address anxiety effectively. With practical strategies such as cognitive restructuring, exposure, emotional regulation and changing the behaviors that maintain that loop of anxiety, CBT aids in managing anxiety and enhancing life quality.

If you’re grappling with anxiety and seeking help, please reach out and discuss with me how CBT can help you. I have over 25 years of experience treating anxiety and you know yourself better than anyone. Together we can use our experience to get to the root of your anxiety.

For personalized CBT treatment, contact Dr. Sarah Allen, an experienced anxiety therapist in her office in Northbrook, a North Shore Chicago suburb, or virtually across IL, FL and the UK. Take the first step to managing your anxiety and feeling more in control of your life today.

Dr. Sarah Allen

If you have any questions, or would like to set up an appointment to work with me and learn how to reduce anxiety, please contact me at 847 791-7722 or on the form below.

If you would like to read more about me and my areas of specialty,  please visit Dr. Sarah Allen Bio.

Dr. Allen’s professional license only allows her to work with clients who live in IL & FL & the UK and unfortunately does not allow her to give personalized advice via email to people who are not her clients. 

Dr. Allen sees clients in person in her Northbrook, IL office or remotely via video or phone.

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