What are the cognitive-behavioral techniques for treating anxiety?

The prevalence of anxiety disorders in the world population is very high. Some studies consider them to be the most common mental disorder, and others the second most common. Cognitive-behavioral techniques for anxiety they are among the most used for this type of disorder.

In this article, we will learn about the five most common anxiety disorders, their basic characteristics and the specific cognitive-behavioral techniques used for each of them, mentioning their usual psychological components and strategies.

    Cognitive-behavioral techniques for anxiety

    Anxiety disorders are one of the most common mental disorders in the world’s population.

    These can be of different types and involve the presence of generalized anxiety in everyday life (generalized anxiety disorder or GAD), the presence of panic attacks (panic disorder) and fear. (agoraphobia) or irrational fear of a specific stimulus, object or situation (specific phobia). Anxiety phobia in social situations (social phobia) is also considered an anxiety disorder.

    As we see, there is a wide variety of anxiety disorders. The treatments used for them also vary, And there are pharmacological options (anxiolytics, antidepressants …) and of course, psychological. The most frequently used psychological treatments are, alongside relaxation techniques, cognitive-behavioral anxiety techniques.

    Let’s see what kind of cognitive behavioral psychological techniques we can use for each type of disorder:

    1. Panic disorder

    Panic disorder, classified as such in the Diagnostic Manual of Mental Disorders (DSM-5), is characterized by the presence of unexpected and recurring panic attacks (2 or more). In addition, the person feels a constant worry about suffering again, or the consequences that result from it.

    The cognitive-behavioral anxiety techniques used in this disorder include two classically known therapies: Barlow’s Panic Control Treatment and Clark’s Cognitive Therapy:

    1.1. Barlow panic treatment

    This treatment includes a prominent educational component. As for its functionalities, treatment includes systematic exposure to interoceptive sensations (Sensations that originate from the internal organs of the body), similar to those that occur during a panic attack.

    Treatment also includes the Cognitive Restructuring Technique, which aims to change the patient’s misconceptions about panic and anxiety. Finally, it includes breathing and / or relaxation training, as well as homework. It should be mentioned that the breathing and / or relaxation techniques used have not been shown to be effective as an isolated component.

    In short, the cognitive-behavioral techniques of anxiety that Barlow offers in his therapy they emphasize exposure to perceptual sensations (And in fact, that’s the hallmark that sets it apart from Clark’s cognitive therapy).

    1.2. Clark cognitive therapy

    Clark’s cognitive therapy, also known as a cognitive therapy program, on the other hand, emphasizes the cognitive component. this therapy it focuses on the development of catastrophic cognitions of the patient, For example: “I will not be able to breathe” or “I will drown”. It also includes testing the patient’s catastrophic interpretations and replacing them with more realistic interpretations.

    On the other hand, it also includes the induction of dreaded sensations, through “experiences” such as focusing of attention, with the aim of showing the possible causes of the sensations felt by the patient.

    Finally, in the cognitive-behavioral techniques of Clark’s anxiety, the therapist recommends that the patient abandon safe behaviors (Like “always with you”, “wearing amulets”, etc.), in order to refute negative predictions about the consequences of the symptoms you have.

      2. Agoraphobia

      Agoraphobia is an anxiety disorder characterized by the fear of being in public places or in situations where it is difficult to receive help during a panic attack or “escape”. like that, fear appears in front of public and unopened places, as is commonly thought.

      Cognitive behavioral techniques for anxiety used in agoraphobia include cognitive behavioral therapy (CBT), which in turn typically includes the following: anxiety and panic education (psychoeducation), controlled breathing, cognitive restructuring, live self-exposure, interoceptive exposure and recordings.

      Its effectiveness may decrease if the time spent on live exposure is reduced. This type of therapy generally produces fewer dropouts and relapses into panic attacks than isolated live exposure techniques.

        3. Specific phobias

        Specific phobias are characterized by an excessive and irrational fear of stimuli, objects or situations that are “harmless”, or that would not necessarily cause these levels of fear and anxiety. For example, it would be the phobia of theft, the phobia of insects, snakes, clowns, darkness, etc.

        In this case, the cognitive-behavioral techniques for anxiety used include certain treatments, such as Ellis’ Rational Emotional Therapy (TRE), Meichembaum Stress Inoculation Training, and Goldfried’s Systematic Rational.

        This type of therapy (CBT) for specific phobia it aims to make the exposure to the phobic stimulus done with the least possible anticipatory anxiety, With more adaptive and realistic attributions of patient reactions.

        4. Social phobia

        Social phobia, as we have already argued, involves excessive anxiety about social situations involving exposure to others, Interacting with other people, attending parties, starting conversations, exhibiting works in public, etc.

        Cognitive behavioral techniques for anxiety used for social phobia include classic cognitive behavioral therapy (which is usually associated with the use of antidepressants).

        In this therapy, cognitive techniques are applied with exposure (fundamental element) to social situations. This is done both in therapy sessions and in homework.

        4.1 Objectives of CBT in social phobia

        The objectives of CBT in social phobia are: to eliminate negative expectations of the patient regarding control of his behavior, suppress recurring thoughts about feared consequences, Focus on the physical symptoms of anxiety and curb the tendency to set perfectionist goals.

        They also include eliminating the tendency to underestimate achievement and ultimately creating the need to be active and focus on what one can do.

        5. GAD (generalized anxiety disorder)

        TAG involves a chronic and nonspecific concern that arises in multiple situations of daily life. A sort of “floating anxiety” appears. This anxiety disorder is the second most common anxiety disorder in the general population.

        The cognitive-behavioral anxiety techniques used for GAD in particular are techniques considered effective and include some of the following: psychoeducation, problem-solving techniques, asking if the concerns are dangerous, and the usefulness of the concerns, exposure of the imagination to the worst. fears, applied relaxation and maintenance of success and prevention of relapses.

        Specific cognitive-behavioral treatments that can be found for GAD are: Brown & Col., Le Barlow treatment, Dugas treatment and Wells treatment.

        Bibliographical references:

        • Belloch, A., Sandín, B., Ramos, F. (2010). Manual of psychopathology. Volume II. Madrid: McGraw-Hill.
        • Clark, D., Beck, AT (2012). Cognitive therapy for anxiety disorders. Bilbao: DDB.
        • Ministry of Health and Consumer Affairs (2008). Consultation tools for the management of patients with anxiety disorders in primary care. Barcelona: Agency for the Evaluation of Medical Technology and Research of Catalonia.
        • Pérez, M., Fernández, JR, Fernández, C., Amic, I. (2010). Guide to Effective Psychological Treatments I: Adults. Madrid: Pyramid.

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