We are spoiled for choice when it comes to therapy. There are literally hundreds available, although in fairness these range from the downright weird and wacky, to more mainstream offerings. When it comes to treating anxiety the most commonly recommended treatment choice is cognitive behavioral therapy (CBT). So, what’s so special about CBT, and importantly, what are its limitations?
Of all the available psychological therapies, CBT is the most clinically evaluated and is generally regarded as one of the most effective treatments for anxiety. It is inexpensive and the overall treatment regimen can last for as few as six one-hour sessions for mild cases of anxiety, but more usually in the region of 10-20 sessions. It has further appeal in the sense that it is perfectly natural and unlike medication, there are no side effects. CBT is most commonly offered as a face-to-face treatment between client and therapist but there is increasing evidence to show that its principles can be applied to a variety of other contexts. Interactive computerized CBT, for example, is on the increase, but CBT can be offered in groups or even in self-help books. These options are attractive to people who find the idea or the practicalities of regular meetings with a therapist don’t suit them.
CBT is a highly structured approach that involves the therapist and client collaborating on treatment goals that are specific, measurable, achievable, realistic, and time limited. The client is encouraged to break down the thoughts, feelings and behaviors that trap them in a negative cycle and they learn skills and strategies that can be applied in everyday life to help them cope better.
There are however some issues with CBT that make it unsuitable or uncomfortable for some people. CBT may not be effective for people with more complex mental health issues or for those with learning difficulties. The focus of CBT is always about the client and their capacity to bring change to themselves. Some people feel this is too narrow a focus and ignores too many important issues like family, personal histories, and wider emotional problems. There is no scope within CBT for personal exploration and examination of emotions, or of looking at troubling issues from a variety of perspectives. For these issue to be addressed a client would need to turn to a different approach, perhaps along the lines of psychodynamic counseling.
Jerry Kennard, Ph.D., is a chartered psychologist and associate fellow of the British Psychological Society. Jerry’s clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.