One way I've used CBT techniques to help patients who are struggling with anxiety disorders is to get them to fill out dysfunctional thought records when they are experiencing high moments of anxiety. This helps them to examine what thoughts are coming up, if there is any evidence to support these thoughts, and then to reframe these thoughts into a thought that might be more logical or rational in the moment. You can then see what happens to their emotional state. I also use these myself for situations I find anxiety provoking (like flying!), and share this with clients as a way of building rapport.
I Ask Clients to Answer this Question: "Is This Thought Helping Me Right Now?" Sometimes anxious thoughts are based in the truth of a person's experience or an accurate assessment of risk. In these cases it's helpful to shift away from evaluating whether a thought is true or not, and towards determining whether the thought is helpful or not. For example, a person who works for a boss with unreasonable expectations and a history of erratic behavior may struggle with the accurate thought that "If I make even a small mistake, I might get fired." In a case like this, I would explore how to find a different job, but that might not be immediately achievable so in the meantime, I would also ask "What are the costs of focusing on this thought right now, even though it's true?" A related question is "Is this thought helping me take productive action in this situation?" This approach helps us focus on effective action in problematic situations, and lessens the power that unhelpful thoughts have on a person's behavior and well-being. Acknowledging the truth of a client's anxious thoughts is also validating for people who are dealing with trauma and have unfortunately been told by therapists or others to just change their thinking. Often, it's just not that simple.
One way I’ve used cognitive-behavioral techniques (CBT) to help a patient with anxiety is through thought-challenging exercises. Many clients with anxiety experience negative, automatic thoughts that spiral into worst-case scenarios. By working together to identify these distorted thoughts, we were able to challenge their accuracy and reframe them with more balanced, realistic perspectives. For example, a client struggling with social anxiety often believed that any social interaction would end in judgment or rejection. We used CBT to break down those thoughts, asking questions like, “What’s the evidence that people are judging you?” or “What’s a more likely outcome?” Over time, this helped the client reduce their anxiety in social situations, as they began to see these thoughts as assumptions rather than facts. This approach empowered them to face anxiety-provoking situations with more confidence and less fear.
One effective way I've used cognitive-behavioral techniques to help a patient with anxiety disorders is through exposure therapy combined with cognitive restructuring. First, I work with the patient to identify specific situations or objects that trigger their anxiety. We then create a hierarchy of these triggers, from least to most anxiety-provoking. Starting with the least threatening item on the list, the patient is gradually exposed to these triggers in a controlled and manageable way, while learning relaxation techniques to manage their anxiety. Concurrently, we use cognitive restructuring to address and challenge the irrational thoughts that arise during exposure. For example, if a patient believes that "If I don’t avoid this situation, something terrible will happen," we work on replacing this thought with more balanced perspectives, such as "I can handle this situation, and it’s unlikely that something terrible will occur." By combining exposure with cognitive restructuring, the patient learns to confront their fears more effectively and develops healthier, more realistic thinking patterns.
As a psychotherapist, I've frequently utilized cognitive-behavioral techniques to help patients with anxiety disorders. One effective method is Cognitive Restructuring, which involves identifying and challenging negative thought patterns that contribute to anxiety. For example, if a patient constantly fears failure at work, we work together to reframe these thoughts into more realistic and positive ones. According to a study published in the Journal of Clinical Psychology, Cognitive Restructuring can reduce anxiety symptoms by up to 60% in some patients. By addressing these distorted thoughts, patients often experience a significant decrease in their anxiety levels, improved coping skills, and a better overall quality of life. This technique empowers individuals to manage their anxiety more effectively and build resilience against future stressors. At JK Counseling, we prioritize using evidence-based techniques like CBT to help clients overcome anxiety and improve their quality of life.
Oh let me count the ways. CBT is so robust when it comes to treating anxiety, which is why I love it. Most people are going to say they "talk back" to the anxiety, and I wholeheartedly agree this is a great skill. I really enjoy working with clients to "act back" when it comes to anxiety. Anxiety is typically sustained and reinforced through avoidance. Clients often come to me and tell me all about the things they DON'T do as a result of anxiety. CBT is a great way to set up a series of harder and harder experiments that can gently push the anxiety back. Over time and with practice the anxiety lessens and the client's world gets just a little bit bigger.
I use CBT with adults and children. For me, using B- behavior techniques often create the fast changes in cognitions. For example, with social anxiety - behaviorally choosing to engage with people and do experiments to see what happens has results in great reduction of anxiety and in increase in confidence. That being said with cognitions learning to challenge thinking, and learning about different types of thinking mistakes can be valuable.
As a mental health advocate and speaker, I have used cognitive techniques like challenging negative thoughts and reframing anxiety-provoking beliefs to help many suffering from anxiety disorders. One young woman I worked with would have frequent panic attacks, convinced she was dying whenever her heart raced or she felt short of breath. I taught her how to identify catastrophic thoughts and replace them with more realistic ones based on facts, not fears. With practice, she learned to tell herself “this will pass” and “I am not in danger” during episodes, significantly reducing their severity and frequency. Another client avoided social situations due to overwhelming worry about being judged or embarrassed. We worked on gradual exposure, starting with a quick phone call to a friend and building up her confidence over time. Each successful social interaction proved her fears were unfounded, slowly rewiring her beliefs through experience rather than avoidance. Progress is often slow but life-changing. Anxious thoughts feel overwhelmingly real in the moment but lose power over time through cognitive techniques and facing situations responsibly. Small steps can lead to big rewards when it comes to overcoming anxiety disorders. Professional guidance provides accountability, support and an outside perspective to help you get there, but the real work is done by the client.