Cognitive therapy for anxiety disorders.

In summary, we conclude that current evidence supports cognitive therapy as a promising approach to the treatment of anxiety. However, definitive conclusions regarding its efficacy must await large-scale, well-conducted, controlled trials that address the methodological shortcomings previously addressed. Furthermore, although there are many components to Beck's version of cognitive therapy, the critical ingredients are not known at this time. Despite the absence of data regarding this issue, we believe that future trials of cognitive therapy should include the following as core components: (a) identifying and modifying idiosyncratic anxiety-related beliefs, (b) using behavioral experiments to test those beliefs, and (c) utilizing well-trained therapists to administer treatment. This would provide a solid foundation from which to evaluate how cognitive therapy might add to the effectiveness of current behavioral treatments for anxiety disorders. In addition, studies comparing treatment effectiveness of cognitive therapy, behavior therapy, and pharmacotherapy for anxiety would ideally include dropout rates, relapse rates, and generalization of changes made over time. The advantages of cognitive therapy approaches may not be evident in the short run because cognitive therapy may provide clients with a method for handling future environmental or internal stresses that might make this treatment approach more effective in the long-term amelioration of anxiety disorders.