Cognitive Behavior Therapy

  • Cognitive Behavior Therapy (CBT) focuses on the ways in which an individual’s thoughts, emotions, and behaviors are all connected and affect one another. This is often referred to as the CBT cycle (see below):
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  • Research supports that CBT is the MOST effective treatment for anxiety disorders, OCD, and depression
  • Sessions are skills-based, goal-oriented, and designed to be short term

  • Treatment focuses on identifying, understanding, and changing the thinking and behavior patterns that affect how one feels

  • Therapeutic strategies may include (but are not limited to): Cognitive restructuring, problem solving, behavioral activation, mindfulness, behavior experiments, emotion regulation, and assertiveness training



Exposure Therapy

The heart of Cognitive Behavior Therapy for OCD and related anxiety disorders is exposure therapy—repeatedly doing the very thing that most terrifies individuals. For a patient with OCD, this might mean purposefully touching doorknobs without hand washing. For someone with specific phobia, exposure might mean driving on the freeway or taking a plane flight. And an individual with social anxiety may be urged to go to the mall to initiate conversations with strangers. 

The basic principle of exposure therapy is that by systematically exposing yourself (purposefully and repeatedly) to the feared situation, sensation, thought, or image, you learn that certain feared outcomes are unlikely to occur and, overtime, your anxiety decreases.  For example, if a child is scared of dogs, the exposure would be to purposefully, repeatedly spend time with dogs until the child learns that dogs are not dangerous and his or her fear subsides. A common question that often arises is: How does this work? A simple, non-clinical way to understand how exposure therapy helps to diminish anxiety is below:

  1. By engaging in exposures, one often discovers that the feared event is highly unlikely to occur and that feared situations/stimuli are not as dangerous as previously thought

  2. Clients see that even if a feared outcome does come to pass, it is not necessarily catastrophic

  3. Clients learn that anxiety and fear themselves are not harmful

  4. Finally, and perhaps most importantly, clients learn that they are capable of tolerating the anxiety that they have avoided for so long