Best Practices for Treatment of Anxiety Disorders
The Canadian Psychiatric Association (CPA) cites a number of meta-analyses which it recognizes as having “clearly demonstrated” the efficacy of cognitive-behavioral therapy (CBT) in alleviating anxiety symptoms. According to these Guidelines, the effectiveness of CBT in the treatment of anxiety symptoms in general is on par with that of antidepressant drug treatment. This appears to be the case in both individual and group therapy settings. For Generalized Anxiety Disorder (GAD) specifically, CBT is more effective than either placebo psychological treatment or no treatment at all.
Some of the common problems that have been identified in GAD sufferers, according to the CPA, include intolerance of uncertainty, inadequate approaches to problem-solving, and the belief that worry is an effective way to deal with problems. In response to these cognitive deficits, therapists commonly utilize psychoeducational tactics, cognitive interventions such as reappraisal of unrealistic beliefs, exposure experiences geared towards the development of tolerance for anxiety-provoking situations, emotion-regulation approaches, problem-solving skills development, and preparation for inevitable periods of increased anxiety. The CPA found that a greater number of these components being used in therapy was predictive of a better treatment outcome, while comparisons between individual components showed little difference. They also found that the addition of treatment components focused on increasing the client’s overall sense of psychological well-being is associated with better outcomes.
There is no current evidence to support routine combination of CBT with drug therapy, according to the CPA.
Citation: Canadian Psychiatric Association (2006). Clinical practice guidelines: Management of anxiety disorders. Canadian Journal of Psychiatry, 51(Suppl 2), 51S-55S.