Can cognitive behavioral therapy help with anxiety?

Cognitive behavioral therapy (CBT) is considered one of the most effective treatments ^[1] for anxiety disorders. It works by helping you recognize the unhelpful thoughts, feelings, and behaviors that allow anxiety to continue. 

CBT also helps people learn self-help strategies to manage their anxiety. It can be successfully used alongside medication, group support ^[2], and other forms of care. If you have an anxiety disorder — or think you might — CBT may offer useful tools and support. 

How does CBT work for anxiety?

CBT helps reduce anxiety by looking at the connections between your thoughts, feelings, and behaviors.

Imagine that you have social anxiety. Anytime you receive an invitation to a party or event, you start to think about all the things that could go wrong. You’re especially worried about embarrassing yourself, unknowingly offending someone, or saying the wrong thing.   

In this situation, a therapist who practices CBT might encourage you to start examining the thoughts driving your anxious feelings. For example, if you unconsciously think, “I’m such an awkward person. I make other people uncomfortable or annoyed,” it makes sense that you’d experience social anxiety.  

Next, your therapist might ask you to gently examine the validity of those beliefs. They may ask you to consider if you have real evidence that those things are true. They may encourage you to recall a time when the opposite of that belief felt true. This exercise, when repeated, may help you reframe your thoughts and, in turn, reduce your anxious feelings. 

In this example, swapping those negative thoughts for one like, “I may not be a social butterfly, but I know my friends like spending time with me,” might help you feel more confident and less anxious. As a result, you might be more likely to attend social gatherings. 

To sum it up, the goal of CBT is to identify and interrupt unhelpful thoughts and feelings to inspire positive behavior change. CBT can’t necessarily erase anxiety from a person’s life. But it can help them change the way they respond to it.

Techniques used in CBT for anxiety

CBT is a broad framework that therapists can apply in many creative ways, depending on the person and the setting. 

Some of the most commonly used CBT techniques ^[1] include:

• Cognitive restructuring: This part of CBT focuses on identifying and reframing unhelpful thoughts. It often involves testing the truth of overly negative or unrealistic beliefs. Some people refer to this as interrupting “worry loops” or the “anxiety cycle.”

• Mindfulness: Mindfulness is the practice of learning to notice what’s happening in your mind, body, and environment without judging what comes up. When applied in CBT, it can increase self-awareness around unhealthy thoughts, feelings, and behaviors.

• Exposure: In exposure therapy (a form of CBT), a person slowly and gradually engages with an anxiety trigger with the support of a therapist. Over time, this can make triggers less upsetting. 

• Psychoeducation: Learning about what causes anxiety disorders and how many people live with them can be an important part of the healing process. This information can help combat stigma and help you feel less alone.

• Homework: Between CBT sessions, your therapist might ask you to apply some of what you’re learning in therapy in your real life. This homework can help reinforce the skills and coping strategies you can use to manage anxiety.

Who’s a good fit for cognitive behavioral therapy?

CBT has helped many people manage their anxiety. 

It might be a good fit for you if:

• You find yourself stuck in catastrophic or “worst-case-scenario” thinking. You’ve tried to change or challenge these thoughts, but they’re difficult to control.

• Your anxiety is keeping you from living the life you want or negatively impacting your relationships or daily functioning.

• You’re willing to sit with some discomfort as you learn new skills or challenge unhelpful thoughts or feelings. Keep in mind that your therapist will be there to offer support and guidance along the way.

• You’re open to talking about your inner experiences. But you’re also seeking tangible strategies for anxiety management.

What to expect from CBT for anxiety

When you start CBT for anxiety, the first few sessions are a time for you and your therapist to get to know each other. Your provider will perform an assessment to better understand your history and concerns. This is a time for you to ask questions too. 

Once your therapist has a clearer picture of your mental health, needs, and preferences, you’ll move into goal setting. Often, this involves setting some short-term goals that will support your long-term goal of reducing anxiety. Keep in mind that you get to decide what you want to accomplish in therapy.

From there, your therapist will introduce CBT activities (both in session and for homework) based on your interests and goals. The frequency and duration of CBT sessions can vary depending on the severity of  your symptoms and other personal factors. However, some people report experiencing anxiety relief after a single session of CBT ^[3]. Over time, you’ll continue to reassess goals, practice coping skills, and learn healthy ways to manage anxiety in your everyday life.

Next steps for starting CBT for anxiety

If you’re interested in exploring CBT for anxiety, get started with these tips:

• Ask for a referral from a current provider, like your doctor or psychiatrist. Let them know that you’re looking for a therapist who’s experienced in using CBT to treat anxiety.

• Search telehealth platforms or digital directories. If you can’t get a referral, you can search online. Filter your results by providers who mention anxiety and CBT or cognitive behavioral therapy in their profiles. 

• Vet potential therapists. When you connect with a potential provider, ask them about their experience using CBT to treat anxiety. Let them know if there are certain aspects of CBT, like mindfulness, that you’re specifically interested in. 

• Schedule a consultation. Once you find a therapist you’re interested in working with, see if you can schedule a consultation. Many providers offer this as an opportunity to ask questions and determine if you seem like a good fit for one another. If they don’t offer consultations, you can always ask initial questions during your first appointment.

Clinician’s take

One shift I listen for is when a client stops treating the worst-case scenario like a certainty and starts treating it like a thought. They might say, ‘That’s my anxiety talking’ or ‘I could handle that if it happened.’ When they begin to trust their ability to cope instead of trying to eliminate every risk, they usually feel more empowered and less overwhelmed.

Brandy Chalmers, LPC

Clinical reviewer