Is Cognitive Behavioral Therapy For Anxiety An Effective Treatment Type?

Medically reviewed by Andrea Brant, LMHC
Updated March 27, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

Living with anxiety can present significant challenges in various areas of life. Your anxiety may constantly tell you, “Look out!”—without really telling you what to look out for or why. Instead, it can keep you in a state of tension and distress and cause uncomfortable physical sensations that prevent you from engaging in the activities you’d like to pursue. Over time, anxiety can grow so severe that you may feel incapable of going to work, making a phone call, or connecting with your friends. You might also experience physical symptoms, such as shortness of breath, nausea, and insomnia. No matter how your symptoms manifest, there are evidence-based treatments available for anxiety. Below, we’ll learn more about cognitive behavioral therapy (CBT) and how this common form of treatment for anxiety can improve your quality of life.

Is anxiety preventing your from doing things you want?

What is anxiety?

According to the American Psychological Association, anxiety is defined as “an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure.” Anxiety can present itself in a variety of mental health conditions, with some of the most common including:

Generalized anxiety disorder (GAD)

Generalized anxiety disorder is persistent and uncontrollable worrying, fear, or dread. Everyday activities often trigger anxiety for people experiencing GAD, such as work, school, family, health, or money.

Social anxiety disorder

Social anxiety disorder is characterized by social interactions causing someone to feel anxious. They might fear embarrassment or rejection when speaking to others and could lead to avoiding social situations entirely.

Panic disorder

Panic disorder consists of overwhelming distress, leading to panic attacks. In addition to psychological distress, panic attacks can also consist of physical symptoms such as rapid heart rate, chest pain, nausea, and trembling.

Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder often develops after a person has experienced a traumatic, shocking, or dangerous event. PTSD symptoms can include distressing thoughts, being easily startled, intense negative thought patterns, and flashbacks. Long term, this disorder can become complex or chronic post-traumatic stress disorder.

Obsessive compulsive disorder (OCD)

Obsessive-compulsive disorder is characterized by unwanted intrusive thoughts or urges that can lead to distress. Common obsessions include fear of germs, fear of loss, or taboo thoughts, while common compulsions include handwashing, organization, counting, or repeating words.

Treating anxiety disorders

If you’re experiencing anxiety, you’re not alone. According to the Anxiety and Depression Association of America, “Anxiety affects 6.8 million adults, or 3.1% of the U.S. population, in any given year.”

Getting the right psychological treatment, such as therapy, may help to treat the symptoms of anxiety. Hundreds of studies have proven that CBT can be very effective in helping to manage cognitive distortions and their symptoms.

What the research says about CBT as a treatment

Extensive studies show that Cognitive Behavioral Therapy (sometimes called cognitive behavior therapy, cognitive behavioural therapy, or CBT) can be effective in treating anxiety. One study titled "Cognitive Behavioral Therapy for Adult Anxiety Disorders," which was a meta-analysis of randomized placebo-controlled trials, proved that CBT therapy is effective in treating anxiety disorders in adults.

Another systematic review titled “Cognitive Behavior Therapy in Anxiety Disorders” stated, "Overall, CBT demonstrates both efficacies in randomized controlled trials and effectiveness in naturalistic settings in the treatment of adult anxiety disorders." The conclusion reiterates the findings by saying "despite some weaknesses of the original studies, the quantitative literature review of randomized placebo-controlled trials and trials in naturalistic treatment settings provides strong support for both the efficacy and effectiveness of CBT as an acute intervention for adult anxiety disorders."

Researchers believe that anxiety disorders are caused by how we think and act, and the way to relieve the symptoms of anxiety may be to identify unhelpful thoughts and address unhealthy behaviors. There are also different types of anxiety disorders, including social anxiety disorders, PTSD, and panic disorders. Treating social anxiety disorders, PTSD treatments, and other types of anxiety can vary, but during therapy sessions, many therapists often teach their patients coping skills for dealing with fear. Coping skills are strategies that therapists can teach their clients or model for them. By employing coping skills at the onset of symptoms, some people may find that their anxiety dissipates.

Medications for anxiety disorders

While CBT is effective for anxiety, certain medications have also been proven effective for reducing anxiety symptoms. The following four classifications are commonly prescribed for people living with anxiety:
  1. Selective serotonin reuptake inhibitors (SSRIs)
  2. Tricyclic antidepressants
  3. Monoamine oxidase inhibitors
  4. Benzodiazepines

There are pros and cons of taking medications for mental health conditions. About half of the people who use medications for mental health or mental illness report experiencing at least some relief from their symptoms. Medication is often readily available, and physicians and psychiatrists commonly prescribe them.

On the flip side, not everyone responds well to medication. About half the people who take them don't experience any relief at all. Many patients who experience improvement with medications only receive a mild (20-40%) improvement in their symptoms. Some people experience uncomfortable side effects from the medication, although they're usually fairly mild. Also, those who opt to take medication to control the symptoms of anxiety may need to stay on it long term. Once they stop taking the medication, their symptoms may return.

Working with a specialist

People who have severe cases of anxiety may need medication and a therapist that can specifically treat anxiety disorders. CBT and therapy techniques can be effective as a short-term treatment for anxiety and may help to reduce social anxiety symptoms. One of the benefits of cognitive behavioral therapy impacting anxiety is that once a person gains coping skills, they may retain them in the long term. Some people find that they can experience significant improvement in a fairly short period, generally within 12-20 sessions of CBT treatment.


Research and clinical neuroscience indicate that CBT is based on the notion that maladaptive patterns of thinking and avoidance behaviors can cause anxiety. Typically, people with anxiety have prolonged exposure to thought patterns in which they tend to think bad things are sure to occur and that they will be more severe than most other people would think they'd be. They also commonly have experienced a traumatic event. When anxiety surfaces, a person may try to avoid certain situations or practice compulsive rituals as a means of coping. In many cases, those who suffer from chronic post-traumatic stress disorder can be at a much higher risk of getting stuck in these thought patterns. 

People living with anxiety may try to escape and avoid situations that make them feel uncomfortable. Since they often have difficulty experiencing certain situations without feeling anxious, they can get stuck in a cycle of feeling fear and trepidation, and they may try to cope by avoiding the situation that causes them to become anxious. Cognitive and behavioral therapies can play a role in helping the person think about the situation in a new way, potentially leading them to behave differently.

How does cognitive behavioral therapy work?

In a CBT therapy session, a client will learn to identify and change the cognitive aspects of their anxiety, such as unhelpful thoughts, behaviors, and emotions. CBT differs from other types of treatment, such as exposure techniques or relaxation techniques, although it may include aspects from each.

CBT for anxiety tends to consist of a set of therapeutic techniques. The client has to actively participate in the treatment for it to be successful. It can also help if the client understands what's involved in their treatment and why they need to practice coping skills. The better the therapist and client understand the origin of the anxiety, the easier it may be to treat it.

Gaining insight into personal history

At first, a CBT therapist tends to take a personal history and assess a person’s psychological functioning. If needed, the therapist may refer the client for a medical or psychiatric consultation to rule out any possible medical reasons for the anxiety. Most people can start CBT right away. People with serious anxiety may need a psychiatric consultation to assess whether they're at a point where therapy and medication will be helpful.

Learning more about your feelings and behaviors

As part of the therapy, the therapist typically helps their clients learn more about anxiety and how it manifests in their lives. Clients may be encouraged to document their positive or negative feelings, thoughts, and behaviors and try to identify situations that trigger their anxiety. Therapists may also use cognitive treatments and techniques such as exposure exercises/therapy, applied relaxation, deep breathing, progressive muscle relaxation, and/or cognitive processing therapy. Exposure therapy techniques are often used for those who experience phobias or anxiety that is based on fear. 

Working together, the client and therapist can map out the client’s symptoms, identify the specific thinking and behavior habits that need to be changed, work on behavioral experiments, and determine the best techniques to relieve the symptoms. These techniques may include short-term strategies for acute anxiety, such as controlled breathing and muscle relaxation.

Examining your inner dialogue and other interventions

The treatment often entails the therapist coaching the client to question themselves about the inner dialogue they have about situations that make them anxious. This is often combined with other psychological and pharmacological interventions, depending on the provider and the needs of the patient. The client may learn how to identify anxious thoughts and replace them with healthier thoughts that are based on rational appraisals of the situation. This is called cognitive restructuring, which is based on the ability to form logical thoughts. Many studies, including this 2022 randomized controlled trial, have demonstrated positive results from cognitive restructuring. 

Is anxiety preventing your from doing things you want?

Bringing new techniques to real-world situations

Once a person learns to adapt their thinking and behavior based on the cognitive techniques that were used, the therapist may have them test it in the real world. They may do this by exposing the person to their fears in small doses under the guidance of the therapist. As they are better able to practice coping skills, the therapist may guide them through more challenging situations. The person may also be encouraged to practice their coping skills at home in between sessions, and they may gain more control over their anxiety the more they practice CBT treatments.

Seeking therapy for anxiety

If you’re experiencing anxiety but don’t feel comfortable with traditional in-person therapy treatments at this time, you might consider online therapy. Online therapy offers several advantages, such as not having to leave the comfort of your home and having a larger pool of therapists to choose from to ensure you find the right fit for your needs. 

CBT has been proven to be effective for treating anxiety, and research has found that online CBT can be just as effective as in-person therapy for this condition. One study published in 2017 found that online CBT was effective for generalized anxiety disorder, social anxiety, phobias, and panic disorders, among other mental health challenges.


Cognitive behavioral therapy (CBT) is a widely used treatment for various anxiety disorders. CBT tends to help people learn to recognize and replace negative thoughts with more positive thoughts, which may lead to more desirable emotions and behaviors. With BetterHelp, you can choose from among thousands of therapists to find someone experienced with CBT for anxiety. Take the first step to addressing anxiety and reach out to BetterHelp today. 

Explore mental health and healing in therapy
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started