What does cognitive behavioural therapy for anxiety involve?

Cognitive behavoural therapy posits that how you think affects how you feel, and that your emotions influence your behaviour. Therefore if you think realistic, helpful thoughts you anxiety will be less and you will function better.

The example below  — for someone who fears having a panic attack on a train — highlights the interaction between thoughts, physical symptoms and behaviour.



You start to sweat and shake


“I feel so sick, I must look terribly anxious, I’ll pass out if this keeps up”


You sweat even more profusely and feel even more dizzy


“I can’t stay on the train. I’ve got to get off at the next stop”


You get off the train and as you exit the carriage your anxiety decreases


“I’m weird and stupid. Other people have no trouble travelling on trains”

A cognitive behavioural psychologist will ask what situations are anxiety provoking for you. The therapist will also elicit what you think and do in these situations.

Cognitive behavioural therapy encompasses:

  • Education about anxiety
  • Cognitive therapy
  • Exposure therapy (both imaginal and ‘real life’ situations)
  • Relaxation training
  • Slow breathing

The psychologist will help you to:

  • identify your unhelpful thoughts and beliefs
  • evaluate the evidence for and against your thoughts and beliefs
  • create more realistic statements you can say to yourself when anticipating or confronting feared situations as these will decrease the degree of anxiety you experience
  • devise a plan for gradually exposing yourself to your situations.

The CBT psychologist will also help you to identify your problematic behaviours and give you strategies to help you cope with your physical symptoms of anxiety. Your CBT psychologist may recommend books and handouts be read and completed as part of treatment.

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