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Cognitive-behavioral therapy (CBT) for panic disorders, for the treatment of anxiety disorders

17 May

Four new studies show that Cognitive-Behavioral Therapy is a first-line treatment for panic and anxiety disorders; that it is extremely and long-lastingly effective for children and adolescents; and very effective for older adults, too..

A review article from the Mass. General/Harvard Medical School reports that Cogntive-Behavioral Therapy (CBT) is currently considered a first-line treatment for panic disorder, as well as a strategy for those who do not respond to medication, and a replacement for those who want to discontinue medication. A short-term intervention, it generally consists of 12-15 sessions of either individual or group therapy. The treatment focuses on helping patients learn about the nature of the disorder and acquire a set of strategies (including relaxation, imagery and other self-regulation skills) that counter the fears of panic attacks themselves, and break the recurring cycle of anticipatory anxiety, panic, and agoraphobic avoidance.

Citation: Rayburn NR, Otto MW.Cognitive-behavioral therapy for panic disorder: a review of treatment elements, strategies, and outcomes. CNS Spectrum. 2003 May;8 (5):pp. 356-62. 

This article reviews the research on the efficacy and range of applications of Cognitive-Behavioral Therapy (CBT) for anxiety disorders. As with panic disorders, the available evidence supports CBT as an effective first-line treatment for anxiety disorders offering longer-term maintenance of treatment gains. There is also evidence that CBT is an effective strategy for pharmacotherapy non-responders, a replacement strategy for patients who wish to discontinue their medications, and a standard strategy for pharmacotherapy patients who need to boost their treatment response.

Citation: Otto MW, Smits JA, Reese HE. Cognitive-behavioral therapy for the treatment of anxiety disorders. Journal of Clinical Psychiatry. 2004;65 Suppl 5:34-41. This email address is being protected from spambots. You need JavaScript enabled to view it.

Researchers from The School of Applied Psychology, Griffith University, in Queensland, Australia, evaluated the long-term effectiveness of cognitive-behavioral therapy (CBT) for childhood anxiety disorders.

Fifty-two clients (aged 14 to 21 years) who had completed treatment an average of 6.17 years earlier were reassessed, using diagnostic interviews, clinician ratings, and self- and parent-report measures.

Results indicated that 85.7% no longer fulfilled the diagnostic criteria for any anxiety disorder. On a majority of other measures, gains made at 12-month follow-up were maintained. Furthermore, CBT and CBT plus family management were equally effective at long-term follow-up. These findings support the long-term clinical utility of CBT in treating children and adolescents suffering from anxiety disorders.

Citation: Barrett PM, Duffy AL, Dadds MR, Rapee RM. Cognitive-behavioral treatment of anxiety disorders in children: long-term (6-year) follow-up. Journal of Consulting and Clinical Psychology. 2001 Feb; 69 (1): pp. 135-41. This email address is being protected from spambots. You need JavaScript enabled to view it.

Researchers at the Department of Psychiatry and Behavioral Sciences of The University of Texas Health Science Center in Houston investigated the efficacy of cognitive-behavioral therapy (CBT), as compared to minimal contact control (MCC), in a sample of 85 older adults (age 60 years and over) with generalized anxiety disorder (GAD).

All participants completed measures of primary outcome (worry and anxiety), coexistent symptoms (depressive symptoms and specific fears), and quality of life. Results of both completer and intent-to-treat analyses revealed significant improvement in worry, anxiety, depression, and quality of life following CBT, relative to MCC. Forty-five percent of patients in CBT were classified as responders, relative to 8% in MCC.

Most gains for patients in CBT were maintained or enhanced over 1-year follow-up. However, posttreatment scores for patients in CBT failed to indicate a return to normative functioning.

Citation: Stanley MA, Beck JG, Novy DM, Averill PM, Swann AC, Diefenbach GJ, Hopko DR. Cognitive-behavioral treatment of late-life generalized anxiety disorder. Journal of Consulting & Clinical Psychology. 2003 Apr; 71 (2): pp. 309-19. This email address is being protected from spambots. You need JavaScript enabled to view it.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award