Use of CBT with Anxiety

Use of CBT with Anxiety

NICE has issued guidelines for four of the six anxiety disorders: Panic, Generalized Anxiety, Posttraumatic Stress Disorder and Obsessive Compulsive Disorder. CBT is the treatment of choice for these conditions. CCBT (Fearfighter) has been recommended to treat phobias. However, specific phobias, social phobias and health anxiety are often treated with CBT because many randomized controlled tests show that CBT is at least as effective as medication or other psychological therapies in the treatment of these conditions.

• Dysfunctional thinking emerges ‘logically’ from beliefs and assumptions – information is processed unhelpfully and can be seen in the NATs.
• Anxiety focuses on the fixation of danger and the perceived lack of ability to cope.
• Anxiety schemas are about danger and ability to cope
• They are maintained by safety behaviours eg always taking someone with them to go shopping. The person then might believe it is the presence of the other person stopping them from fainting/being sick etc.

Panic

• Fear of bodily responses – sensitive to changes in bodily sensations, misinterprets the meaning, begins to fear panic itself rather than the original stimulus e.g the supermarket.
• Fear is generalised to many situations. The person believes the supermarket makes them ill (panic) but then it might be public transport, or eventually outside of their home.
• Sensations are catastrophised, selectively attended to, and avoidance and safety behaviours maintain panic. The feeling of adrenaline is feared and exaggerated, people often think they will have a heart attack or faint, so they only go to the supermarket with their spouse, or won’t go at all. Avoidance and safety behaviours mean that they never disprove their original hypothesis: the supermarket is dangerous.