Cognitive – Behavioral Therapy
Cognitive-behavioral Therapy or CBT identifies anxious patterns of thought and behavior that keep unwanted symptoms in place. Using CBT methods, which are learned in therapy sessions, people learn to cope with anxiety-producing situations, and learn to control thoughts and behaviors that keep anxiety in place or harm them socially and emotionally. Individuals are at all times involved in planning and practicing techniques for their recovery.
Relaxation Techniques such as diaphragmatic breathing and muscle relaxation help individuals to diminish physical symptoms of anxiety.
Medication is often used in conjunction with psychotherapy mentioned above. It is often not necessary but may be very helpful. The typical medication choices include the Selective Serotonin Reuptake Inhibitors (SSRIs, which are often confusingly called “antidepressants”) and limited use of benzodiazepines for anxiety reduction.
Choosing a Therapist
Anxiety disorders can be treated by a wide range of mental health professionals, most typically psychologists and clinical social workers or counselors. All psychiatrists and most primary care physicians will prescribe medication for anxiety, but they do not usually offer the therapy methods that can teach a person to control anxious symptoms. Finding the right therapist is not always easy, as competent therapists with good credentials do not always practice the pragmatic style of thought and behavior management that works best with anxiety symptoms. Ask your doctor for a referral or look on the Anxiety Disorder Association of America website (www.adaa.org) for a list of therapists in your area who belong to the association. You are also likely to find a therapist who treats anxiety well among therapists who specialize in trauma. Try the Eye Movement Desensitization and Reprocessing International Association website (www.emdria.org) for a list of therapists who are trained in that method in your area.
When you find a therapist in your area, ask to speak to that person before you schedule an appointment. Do not hesitate to ask questions of the therapist you are considering about the training, style of working, and relevant details about the therapy sessions: times, costs, etc.
Questions to Ask
- What Training and experience do you have in treating anxiety? Ask specifically:
- What is your therapy approach to anxiety? (Ask about your type of anxiety.)
- What kinds of cognitive techniques do you use?
- Do you give “homework” assignments?
- What methods might you recommend for panic attacks?
- What do you believe about the need to get rid of underlying causes of anxiety in order to get rid of symptoms? You should get an answer that suggests:
- symptom management may be possible without long term work AND
- if anxiety is caused by unresolved issues (such as a previous trauma), it will come back unless the person deals with those issues.
- How frequently will you expect to see me, and how long does one session last?
- Do you include family members in treatment?
- if seeking help for a child, parents must be included,
- and it is a good idea for a spouse to hear about the biological nature of anxiety and to learn from the therapist how to respond to the complaints of anxiety that come up at home).
- What is your fee schedule?
- ask for details about insurance coverage, sliding fees, etc., and
- ask about community resources for special financial circumstances.
Remember, if a therapist is skilled in treating anxiety, the answers to the above questions should be clear and direct. Any therapist who is vague or reluctant to answer your questions may not have the skills you need to improve your anxiety rapidly.