Cognitive Restructuring for Anxiety Disorder

Cognitive restructuring is a technique used in cognitive behavioral therapy (CBT), a therapy that focuses on the role of thoughts and behaviors in mental disorders. Cognitive restructuring can help reduce symptoms in people with anxiety disorders such as post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), social phobia and obsessive-compulsive disorder (OCD).

Rationale

• The idea behind cognitive restructuring is that feelings of anxiety can be minimized or eliminated by changing the person's thought process in reaction to the anxiety-provoking stimulus. Restructuring techniques teach the anxious person to think about the particular fear or anxiety-provoking situation and, ultimately, with the help of a therapist, change this fear or belief into a more manageable thought. This, in turn, will help to reduce, or eliminate, the anxiety that was previously triggered by that situation.

Goals

• There are three steps in the cognitive restructuring process. The first is to identify the specific cause of the anxiety. Restructuring is unlikely to work unless the correct fear or thought pattern is the focus of therapy. The second step is to challenge the anxiety-producing potential of this thought. In this step, the therapist helps the patient dispel the irrational thoughts that provoke the anxiety. It is in this step that irrational beliefs lose much of their power over the patient. The final step is to convert the anxiety-provoking thought into something that, instead, induces relaxation. The final goal of therapy is to give the patient the tools he needs to remain calm under difficult circumstances.

Strengths

• There are quite a few strengths of cognitive restructuring for the treatment of anxiety disorders. First, this technique teaches clients that they have the power to change the way they think about and perceive undesirable situations. This empowers clients, teaching them that they can change experiences by changing thought patterns, even if the environment stays the same. Another advantage of this method is its brevity. On average, this type of therapy only lasts for about 16 sessions. Perhaps the biggest benefit, however, is its potential for lifelong use. Once these restructuring techniques are learned, they can be used in virtually any situation.

Limitations

• There are two main limitations of this therapy technique. One is that it is difficult to learn these techniques in any other setting. This can create a problem for those who would rather avoid seeing a therapist. The other limitation is that, because therapy is often limited to an hour or two per week, therapists often assign "homework" to be completed before the next session. For those with a busy schedule, this is something to be considered when weighing treatment options.

Success Rates

• The use of cognitive behavioral therapy has, in general, been regarded as effective in the treatment of anxiety disorders (see Resources). Like any other form of psychotherapy, success of treatment depends largely on the amount of effort directed at getting well. Cognitive therapy techniques are most effective for those who attend therapy regularly and complete all assigned tasks between sessions.