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Cognitive Behavioral Therapy: CBT Techniques for Anxiety & Depression

Cognitive Behavioral Therapy Techniques

CBT techniques, or ‘cognitive behavioral therapy techniques’, refer to the various methods used to redirect or change human behavior. Two of the conditions cognitive therapists often treat are anxiety and depression. The ultimate goal of the cognitive therapist is to destroy bad thoughts and replace them with good thoughts, affirming thoughts – because what a person thinks is believed to determine how a person acts.

cognitive restructuring and exposure, Rational Emotive Behavioral, DBT

Cognitive behavioral therapy (CBT) entered medical history because of Dr. Aaron Beck at the University of Pennsylvania, who discovered it in depression treatments. CBT treatment has since extended to anxiety.

In addition to depression or anxiety, the following issues are treated by cognitive behavioral therapy:

CBT Worksheets

CBT worksheets are what cognitive therapists use to assess their patients’ experiences. The worksheets ask questions such as “What do I do when I feel anxious?” or “What negative thoughts occur in my head most?”

For young children who battle bipolar disorder, the cognitive worksheets are used to help bipolar children express an experience they had, their thoughts at the time the event took place, as well as how the child interpreted the event. The goal of the worksheet is to help the child see that, when certain things take place, he or she thinks certain thoughts. If the child can see the connection between events and thoughts in worksheets, then maybe they can realize the problem and turn their thoughts in a different direction the next time the same event happens. Cognitive therapists give children a diary that accompanies the cognitive worksheets.

CBT Techniques for Anxiety

Cognitive behavioral therapy for anxiety is an important tool to help break the cycle of negative thought patterns that can create feelings of overwhelming panic and helplessness.

Effectiveness of cognitive behavioral therapy for anxiety

Cognitive behavioral therapy for anxiety has been shown to be highly effective at helping those who suffer from anxiety to regain control of their mind and actions by helping them understand why they do the things they do and how to change their negative behavior.

This approach to treating anxiety has been shown through a significant body of research to be highly effective. NCBI article on cognitive behavioral therapy in anxiety disorders concludes: "the meta-analyses confirm that CBT is by far the most consistently empirically supported psychotherapeutic option in the treatment of anxiety disorders".

Cognitive behavioral therapy involves working with a qualified professional who will outline the concepts of distorted thinking, help you identify your negative thoughts, and give you assignments to work on at home that will teach you to change your wrong beliefs.

The secrets to its success are that you need to have an open mind on the process, do the work assigned by your therapist, and be prepared to confront uncomfortable thoughts. It might be hard at first, but those who stick to it find the rewards are more than worth the effort.

How does cognitive behavioral therapy work for anxiety?

Beginning in childhood, we learn a set of coping skills that we rely on to get us through stressful situations. As well, a traumatic event can affect our reactions to certain circumstances. If your reactions are consistently out of proportion to the actual threat being presented, this is known as cognitive distortion. When you’re distorting the situation in your mind, your ability to cope will lessen and your anxiety will increase.

Therapy, along with learning to understand the causes of your anxiety and why some thoughts trigger this response, can liberate you. The negative thought processes can be transformed into a more positive way of thinking. When you make the effort to look closely at many of your thoughts, you may even be able see exactly how your childhood coping mechanisms or a traumatic event influence your reactions.

For example, say you are afraid of snakes because you stepped on one when you were little and it bit you. Now you have the chance to take a trip to the zoo but decide not to go because you’re anxious that the snakes could escape from their enclosures and bite you. Even thinking about getting bitten again makes you feel like you’re going to faint. Your heart begins to pound and your head starts to throb. This is a physical reaction to the fear of what might happen.

When you feel fear, your body will react as if danger is present. If you become frightened that strong winds whipping through the trees could cause them fall down around you, your body will release adrenaline in response to that fear. When you are truly in jeopardy, the adrenaline will give you a surge of energy to help you flee from danger so as to keep yourself safe. That’s a normal, appropriate response. But when you experience fear over things that aren’t dangerous, and might not even happen, that’s a problem.

We all believe in something, but not everything we believe is accurate. It’s possible to take beliefs that are helpful and appropriate and mix them up in our heads with beliefs which can be destructive and inaccurate. For instance, you worry about getting fired from your job. There are no clear signs that something like this will actually happen, but still you become anxious. Not just occasionally, but constantly.

The idea behind cognitive behavioral therapy is that if you are able to identify your inappropriate responses, you will be able to replace your distorted thoughts with a more realistic view, thereby reducing or eliminating your anxiety.

Everybody has fleeting thoughts where a pang of fear or anxiety will come to mind. That’s just a normal part of life. But if the thoughts don’t go away, if they hang around and we listen to them as they loop through our minds repetitively, that indicates a serious problem. Cognitive behavioral therapy for anxiety teaches the mind to interrupt that loop and enables you to move past the place where you’re trapped.

What are the best CBT techniques for anxiety?

Cognitive Restructuring And Exposure Therapy

The best CBT techniques for anxiety are cognitive restructuring and exposure therapy.

Cognitive restructuring is self-explanatory: the cognitive therapist uses this technique to ground the patient’s thoughts in something that corresponds to reality.

A patient may walk into a cognitive therapist’s office, worried about a big speech or presentation he or she has to give in a week or so. He or she may feel worried about how the presentation will go, or have sweaty palms and overwhelming fear of the event’s outcome. The cognitive therapist will enact the scene with his patient, trying to help the patient place himself or herself in the actual event – though it is still a future event. The goal is to get the patient in a position to see his reaction, discuss why he has the reaction he does, and discuss times in which the exact opposite happened.

In the case of the business employee, the cognitive therapist will try to help the patient recall times in which he or she expressed confidence in speeches and presentations. The goal of such discussion is to help the patient see that to presume he or she will fail in their presentation is a false assumption – and why assume the worst when things could go well? Placing the patient in times of success can help to reduce the sweaty palms, stammered voice, and frightened appearance in public – all symptomatic of cognitive distortions.

The next cognitive behavioral therapy technique for anxiety is exposure therapy. The term ‘exposure’ therapy is self-evident: this therapy ‘exposes’ the patient to face fear head-on.

For example, if a patient has a fear of heights, the cognitive therapist may take the patient to the top of the therapy clinic and walk him near the edge of the building. The therapist may do this repeatedly until the individual can walk on the top of the building without clamming up, getting sweaty palms, and panicking so quickly.

If the patient has a fear of snakes, the therapist may take the patient to a snake owner’s estate and allow him or her to walk around and see the various snakes in aquariums or cages – to convince the individual that there is no reason to fear snakes. The cognitive therapist will do this until the patient no longer fears snakes as much.

CBT Techniques for Depression

There are two CBT techniques for depression – (1) rational emotive behavioral therapy and (2) dialectical behavior therapy.

Rational Emotive Behavioral Therapy

Rational emotive behavioral therapy is a cognitive method whereby patients are taught to think and place their emotions in check.

A good example of this strategy on display is a patient who has been seeing his therapist about his hurt and grief over his girlfriend ending their relationship. For the last two years, the man has been licking his wounds, hurting over her, unable to date or see someone else. After two years, he still visits his therapist about the situation. How does the cognitive therapist respond?

He begins to talk about how the patient’s old girlfriend has moved on with her life – while he sits on the sidelines and will not even date. The therapist does this to help jolt the patient and remind him that, while he pines away for his former girlfriend, he is missing a valuable opportunity to date and eventually meet that special someone that he will marry. In one meeting, the patient finally gets what his therapist has been saying – and the goal of rational emotive behavioral therapy has been achieved.

Dialectic Behavioral Therapy (DBT)

Dialectic behavioral therapy (DBT) is a therapy system that treats people with borderline personality disorder (BPD). While dialectical therapy involves cognitive behavioral techniques, it also includes some elements of Buddhist meditation, one of which is mind awareness.

DBT was first discovered by Marsha M. Linehan, a researcher in psychology at the University of Washington. Linehan found that dialectics were a positive form of dialogue exchange between therapist and patient. She learned, through discussions with her patients (who seemed to have personality disorders or something close to them), that she could help patients by showing them moments in which their judgments accurately reflected reality.

In each session, Marsha would show patients that some of their views rightly reflected reality, while others were distorted or twisted. Through an affirmation of ‘stay and change’ with her clients, she was able to reach many who were on the verge of losing themselves – and helped bring them back to reality (with their co-operation and self-determination).


When someone is undergoing CBT techniques, the goal of the cognitive therapist is to move the patient into a more positive direction. CBT techniques are used for the sole purpose of helping redirect the thought processes of scared, frightened, or mentally disoriented individuals whose view of reality differs from reality’s true form. Patients often go to therapists believing that the cure is in the mind of the therapist; surprisingly, therapists are showing patients that the cure is within. With a little encouragement, patients have all they need to face their reality – as it is.


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