A job loss isn’t always the easiest thing for people to cope with, especially during a time of a global pandemic. Of course, you’re not alone, as there are over 40 million other people in the nation who are out of work, and many needing to depend on unemployment benefits. There’s a correlation between job loss and depression, and an even higher correlation the longer one is without a job. It’s no wonder that we’re seeing more emotional distress, including depression.
Healthline explains how treatment with Cognitive Behavioral Therapy, focusing on addressing moods, thoughts, and behaviors, can benefit those suffering from depression by creating daily routines, setting reasonable goals, developing an exercise or activity regime, etc.
For more examples of how CBT can be used to combat depression see
According to the blog, Be Yourself, unlike most disorders, there is no diagnostic testing for OCD; however there are diagnostic interviews that can help to determine the severity of the disorder.
The blog further says that medications like antidepressants have been less effective in treating the disorder, whereas Cognitive Behavioral Therapy has shown great success. Through exposure and response prevention (ERP), CBT has been proven to be the most effective cure for disorder.
With more than 30% of Americans experiencing insomnia, the American Academy of Sleep Medicine (AASM), Society of Behavioral Sleep Medicine (SBSM) and the American Alliance for Healthy Sleep (AAHS) have all teamed up to raise awareness about insomnia by observing a night, June 22, 2020 to provide education and support to those experience this disorder.
The number one treatment for chronic insomnia is Cognitive Behavioral Therapy. From setting a consistent sleep schedule to replacing fears about sleeplessness with more helpful expectations and more!
For more information on Cognitive Behavioral Therapy and how to treat Insomnia see
photo courtesy Claudio Scott
How CBT helps Anxiety
Approximately 7.3% of the worlds population is suffering from anxiety disorder, a form of mental disorder, causing overthinking, unnecessarily worrying, heavy breathing and even panic attacks in some cases.
Treatments such as Cognitive Behavioral Therapy have been proven to be effective in more than 70% of cases due to its six stage treatment.
The treatment is organized in a way to completely eliminate the disorder by determining the cause of the anxiety in the patient, eliminating symptoms and the steps to healthy mental stability.
For more information on how CBT can help treat anxiety see
Cognitive Behavioral Therapy (CBT) is known as a first line treatment for panic attacks, proving to be effective for about 77% of patients. CBT therapists encourage patients suffering from panic attacks to confront their feared situations and sensations under safe conditions.
In addition, clinicians assist patients in methods to overcome their fears of panic attacks by refocusing thoughts and using guided imagery. Lifestyle changes, like dieting, breathing exercises, mindfulness meditation and exercise, can also play a role in managing symptoms.
For more information on how CBT can be used to treat panic attacks see
Involving Parents in Their Children’s Anxiety Treatment
Parenting and managing the uncertainties that come with a pandemic hasn’t been the easiest, however many are seeing the light at the end of the tunnel with the help of Cognitive Behavioral Therapy. CBT treatment has been used to determine how rational someones subjective interpretation of an event is. Countless individuals feel the pressure of ‘Perfect Parenting’ especially during these these imperfect times however as Lindsay Brauer, Ph.D. mentioned in Psychology Today “How can we be perfect during imperfect times”. Riding the waves of change, becoming more flexible and have more self-compassion are just some examples of coping.
For more information on how CBT can assist with parenting during a pandemic see
Several ABCT members give you, via the New York Times, tips for your first holiday outings in the new pandemic world. Prepare your stock of PPEs and prepare for holding your own space. But once you leave the house, abandon future-thinking and be utterly in the present.
Jenny Taitz walks you through the things that are likely to help keep depression, anxiety, and even PTSD at bay even while going through these tough times. She notes that negative beliefs predict the risk of PTSD and that negative feelings are self-fulfilling; and she gives us tips for avoiding those very predictors of poor outcomes, like avoiding rumination by putting negative thoughts on paper as a way to be done with them.
A useful article quoting some of CBT’s most important researchers
Photo courtesy of ShiftGraphiX
Suicide rates were already rising before the pandemic exacerbated many of the stressors that might lead to suicide. Clinicians talk about those stressors and offer some tips for reducing their impact.
More than two million people are seriously injured every year by car accidents for reasons such as but no limited to, drunk driving, not wearing seatbelt, disobeying speed limits etc.
News Channel Nebraska explains how not only are people physically affected from car accidents but that it also imposes mental trauma in many cases. As we know, CBT is used widely to treat emotional trauma.
Therapists use this form of therapy by using rational questioning to disrupt anxiety, depression and phobias. The purpose is to explore and develop a treatment plan to minimize the impact that trauma has on your life.
Kevin Arnold and Mary Fristad guide us through the anxiety we might likely expect when the world is open for business again in the, hopefully, not-too-distant future. Embrace and manage your anxiety; don’t ignore it, is one of the many pearls offered.
Dean McKay, a researcher and clinician specializing in OCD and disgust, reassures the public that our healthy precautions taken to contain the spread of COVID-19 are unlikely to morph into germ-focused OCD.
Stefan Hofmann and Michael Addis join Meghna Chakrabarti on WBUR’s On Point to discuss anxiety, especially from a male perspective. They provide a lively back and forth roundtable with callers, exploring the perceived extra difficulty males might have in even admitting it, as well as those long-standing, unstated expectations many males might have. It’s an enjoyable and informative 45 minutes, with additional excellent accompanying text, some of which have previously also been featured on this site.
For those who want to explore healing, we have fact sheets that describe Trauma, PTSD, Grief
In addition, people might be interested in how anger and rage fit into the story, and ways that they can be addressed. Please see our fact sheet on anger; you might also take a look at our directory of self-help books, including one on dealing with anger
Our hearts break for those who were killed, those who were hurt, those who have lost family or friends, and those who, like us, just share in the pain of the recent tragedies in El Paso and Dayton. As researchers and therapists who devote our lives to treating people on the wrong end of tragedy, we work to help. For those who want to explore healing, we have fact sheets that describe
Trauma, PTSD, Grief.
In addition to sending our support to victims of the recent shootings, ABCT strives to be a welcoming and inclusive organization and we want to recognize the particular kind of harm incurred by racist attacks like the one that took place in El Paso this weekend. The target of these attacks was a community that has historically been a welcoming haven for immigrants and Hispanics/Latinxs. ABCT aims to support research and evidence-based clinical care by and for these exact groups. We reject the narrative that these acts of violence are a "mental health problem" as opposed to a mix of factors, including racism, cultural norms around gun violence, and radicalization of youth through the internet. To place the burden on evidence-based practitioners to predict these acts of unspeakable violence ignores the significant structural and cultural forces that give rise to such attacks, in turn leading to further marginalization of the targeted groups.
For those who need further help, please consult our directory of CBT Therapists
How do parents talk to their kids about vaping. Therapists, including Mary Alvord, share strategies with the WSJ’s Andrea Peterson.
It's a treat to wander into an office and find that the therapist is so passionate about his work that it dominates his shelves, walls, window sills, and hallways.
No, not the usual framed diplomas, diplomates, and board certifications but baubles, tchotchkes, games, finger puppets, and posters celebrating Freud, delirium, fear, and stability or its absence.
Barry Lubetkin, the son of an antique dealer managed to meld his love of the old and unusual with his devotion to making people better.
Have a look and see his phrenology chart, dip your finger into his jar labelled "mid-life crisis," or take a gander at the poster warning us to "Fear the Future and Regret the Past."
It’s actually an important question, at least as posed and answered by Lucas LaFreniere and Michelle Newman in their forthcoming Behavior Therapy article, “Exposing worry’s deceit: Percentage of untrue worries in generalized anxiety disorder treatment.”
Psychology Today called it an “essential read,” and it explores the very low percentage of worry that actually comes true and the improvement in treatment when the discrepancy between worry and reality are highlighted.
The journal Practical Pain Management identified CBT as an effective aid in sleep management, often giving people more restful hours.
In the article, authors quoted a study comparing CBT to drugs, stating “CBT raised the patients’ average slow-wave sleep 27 percent by the end of treatment, and had increased it 34 percent six months later.
Patients who took the sleeping pill had a big drop in the amount of slow-wave sleep. They had 20 percent less slow-wave sleep at the end of treatment, and six months later, they had 23 percent less slow-wave sleep.”
In effect, their study showed that CBT added sleep and sleeping pills actually reduced sleep.
This article in US News highlights CBT-I - Cognitive Behavioral Therapy for Insomnia. While some jump to medication for treating insomnia, CBT is actually the first line treatment for sleep problems, as the benefits of treatment continue past the end of therapy, while medication only work when an individual is taking it. ABCT member Michael Perlis explains that the treatment has four components: sleep restriction, stimulus control, sleep hygiene, and cognitive therapy. Often it’s counterintuitive, too, like with sleep restriction. One might think that if you can’t sleep you should stay in bed for longer. But actually experts say it’s important to match your sleep opportunity, or how long you’re in bed, with how long you’re able to sleep, and then gradually work on increasing sleep time.
Of the problems that the article lays out is access - finding a therapist who uses CBT-I can be a challenge. To that end, however, ABCT's find a therapist directory can help. To search for a therapist, click here
A recent scientific study analyzing CBT's effectiveness in treating anxiety in patients undergoing treatment for pulmonary disease found CBT beneficial, both in terms of the patient's anxiety and in reducing the number of hospital visits and medical costs.
To read more about the study and its importance to people, see
Earlier this year, RadioLab recounted how one psychologist came to argue against conversion therapy.
That documentary was featured here, and the psychologist in question, Gerald Davison, was then president of this organization. A mere 45 years later, New York State will be joining 14 other states and the District of Columbia in banning the practice.
To hear the piece from RadioLab on Dr Davison, see
photo courtesy filmbetrachterin
Maltreatment and Suicide
ABCT member Mitch Prinstein comments on the following article related to the link between childhood abuse and adult suicide.
This article offers a spotlight on the remarkably high rates of suicide among individuals across the world who have experienced physical, sexual, or emotional maltreatment in childhood. Suicide remains an extraordinarily high priority area for psychological research and for treatment development, as few treatment approaches have demonstrated efficacy for reducing future suicidal thoughts and behaviors. Moreover, although researchers have identified a host of distal risk factors that may increase the likelihood of suicidal behavior months or even years later, remarkably little is known regarding the proximal processes that may occur between a stressful experience and an individuals’ consideration or engagement in suicidal behavior. These are important directions for psychological scientists to consider, and exciting areas of inquiry for young scholars who are looking for research topics that need greater attention, with findings that can have maximal impact on saving lives.
To find a provider who can help, check out our Find A Therapist directory here
Create your own traditions
Holidays create stress for some, and more for those of us having some mental health issues. Overly high expectations, poor self-care with the overabundance of comfort foods available, strained budgets and more can all contribute to stress.
But there are good strategies to employ, suggest some CBT practitioners.
This article, from New York magazine’s The Cut, discusses intrusive thoughts experienced by many new parents. Former ABCT president Jon Abramowitz is quoted as saying that every new parent has intrusive thoughts of harm befalling their baby at one time or another.
Occasionally, this common thought pattern can become persistent and distressing to the point of developing postpartum obsessive compulsive disorder.
Abramowitz and fellow anxiety researcher Nichole Fairbrother began collaborating after themselves experiencing intrusive thoughts as new parents.
Their research asserts that such thoughts occur in stressful situations, and that, like standing at the top of a tall building, the early stages of parenting falls into this category .
Once upon a time, both Leviticus and DSM considered homosexuality an affliction to be cured. Today, people still occasionally quote Leviticus (skipping over the parts on shaving, shellfish, and mixed fabrics), but psychology is virtually unanimous in its acceptance of homosexuality.
In the 60s and 70s, the debate on homosexuality was only just beginning, and Jerry Davison, one of CBT's pioneers, took a controversial stand, calling aversion therapy, the tool most often used in trying to alter a person's sexuality, immoral when used with homosexuals.
How he came to this position is fascinating, and provides a window into a debate that has ramifications for millions of people. For many of us today, its seems perfectly natural; it's easy to miss just how radical, and how courageous, such a position was forty years ago.
Listen to more of this story told in a way that draws us in further with every twist.
This article in the Washington Post outlines the case for using timeout as a discipline technique for young children.
Written by ABCT members Camilo Ortiz, Anne Marie Albano, Mitch Prinstein, Regine Galanti, Dan Hoffman, Tim Cavell, and Hillary Vidair, it dispels several myths about effective, evidence based discipline. And, even better, it gives a detailed approach in doing time outs perfectly.
EveryDayHealth.com, examining a 2013 study in the European Journal of Pain and a 2011 study in the Journal Arthritis Research and Therapy, explored how Cognitive and Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) successfully managed pain in fibromyalgia. In the Pain study, ACT had positive effects on pain-related functioning, mental health–related quality of life, self-efficacy, depression, and anxiety in 40 women with fibromyalgia. The participants attended 12 weekly group ACT sessions. In the Arthritis study, CBT was helpful in reducing pain catastrophizing in people with fibromyalgia. Catastrophizing, generally, is believing that something is — or will be — much worse than it actually is. In pain catastrophizing, a person magnifies the actual or anticipated pain he’s experiencing.
There was lots more in the studies, including combatting "pain fog" and working around fatigue.
To read the full article, which includes links to the research articles discussed, see
For those looking to talk to a CBT therapist, including those who use ACT, see
As many as one quarter of adolescents experience anxiety; and around 6% of people have anxiety their entire lives. According to Emily Bilek, who treats children and adolescents, normal fears are adaptive, but when anxiety interferes with life, or it becomes a "presence," and the sufferer or someone in the family says "something's got to give," it's time to seek help. She said the cause of the anxiety isn't important; treatment will have a positive effect, and CBT is the gold standard of care.
Bilek says that avoidance (of the thing that makes us anxious) narrows life. Often, anticipating the fear or even the physical changes that come with the anxiety is often worse than the thing feared.
We tend to over-predict negative outcomes and under-predict our own resiliency.
For the entire interview, see video ; for those interested in how we might treat, look at minute 13.
A little nervousness is good, especially with unknown situations, such as a new school with new kids, new teachers, new subjects. But some of our kids experience a LOT of anxiety, so much so that one in four meet criteria for a doctor to diagnose them as having anxiety.
And, according to doctors quoted in the Washington Post , anxiety is underreported.
How can a parent tell if his, or her, child is anxious, rather than nervous? According to Mary Alvord, it's likely to be anxiety if the child's fears and actions get in the way; or if the parent is accommodating the child.
For more on anxiety, see ; for more on school refusal, see
Teens are facing monumental changes in their world. More options, greater access to more things, and different social interactions. Good? Or Bad? Those changes, and the effects they're having on today's teens, are discussed by a number of prominent psychologists who specialize in helping children and teens.
Based on what books are selling, this seems to be true, especially among people living in traditional "blue" states, and not so much in decidedly "red" states.
The Washington Post puts this in context in a fascinating article, and even provides some resources, including, drum roll please, us. A number of prominent psychologists are quoted, one each from a red, blue, and purple state.
For more on anxiety, see
or, for one of many books on the subject, see our recommendations at Self-Help Books
Shaq and Shark
CBT helped Shaq overcome his fear of sharks:
This article from The Inverse outlines Shaq's course of Exposure Therapy, and quotes ABCT member Mitchell Schare in describing how Exposure Therapy works to reduce fears. What a role model! Stories like this reduce mental health stigma.
OCD and Doubt
This article in Self magazine describes the role of reassurance-seeking in OCD. OCD is a disease that thrives on doubt and uncertainty in a world where certainty is not realistic. The article describes the concept of accommodation, when family members and friends "give in" to the OCD by answering reassurance-seeking questions. While this allows someone suffering from OCD to feel better in the short term, it exacerbates the symptoms in the long term. Instead, CBT for OCD helps people realize the role of this reassurance and reduce it, often through responses that might initially come off as counter-intuitive and unsupportive.
The Washington Post outlined various approaches to relieving back pain. The paper outlined the steps to take, and the order in which to use them. CBT is suggested immediately after exercise and yoga and well before meds, acupuncture, chiropractic. Surgery is below the fold. The recommendations for CBT for back pain are from Consumer Reports and are based on the results from a JAMA study. Interestingly, if one is looking for a therapist, the paper suggests going to ABCT's website. Well, congratulations, all you well read people: you found us.
And, for a therapist, like the good people at Consumer Reports and the Washington Post recommend, see
CBT for Health Anxiety
The New York Times addresses CBT for Health Anxiety in this article, "A New Approach to Treating Hypochondria." Jane Brody describes health anxiety as a vicious cycle: "health-related fears can be exaggerated by physical symptoms that develop as a result of anxiety about being sick or getting sick. Anxiety itself can cause a rapid heart rate, chest pain, nausea and sweating that patients then misinterpret as a sign of physical illness. "
Though this type of therapy is not new, CBT helps patients recognize unhealthy beliefs and learn to cope with anxiety provoking situations.
ABCT member Judith Beck outlines the ways that Cognitive Behavioral Therapy works as an effective treatment for suicidality. She describes how creating a safety plan provides hope, and how CBT uses clear steps to teaching people to solve problems and prevent relapses.
It's not just celebrities; in fact, suicides are on the rise across the country, in 49 of our 50 states. Ben Carey, in the New York Times, traces some of the probable causes, and the correlational statistics attending them.
Carey notes that the "biggest increases have been in states like Oklahoma, Montana and Wyoming where gun ownership, drug use and economic hardship are common. Among middle-aged people across the country, marriage rates have declined, and social isolation has increased." Carey is careful not to say that more guns, higher drug usage, and increase poverty are the reason, but he notes their increased presence and increased suicide rates.
To add evidence, though, to the impact of the availability of guns on suicides, Carey notes that "a handful of states have passed legislation allowing authorities to seize firearms from people deemed mentally unstable or 'dangerous.' In a study of these laws in two states, Indiana and Connecticut, researchers at the University of Indianapolis found that the legislation led to reductions in gun-related suicides, compared to the expected numbers: they were 7.5 percent lower in Indiana in the decade following enactment, and 13.7 percent lower in Connecticut in the year since strict enforcement began.
For a list of treatment providers who work with depression and suicide, check out ABCT's Find-A-Therapist page here
Parenting behavior can have a large impact on childhood independence. Andrea Peterson lays out the research on childhood independence for her article in the Wall Street Journal. ABCT member Alan Kazdin recommends that parents encourage their children to "practice" independence in small, low stakes situations. Others encourage children to begin helping with household chores from a young age, with the ultimate goal, according to former ABCT president Anne Marie Albano, of having children be self sufficient by the time they leave to college.
NPR features the Resilience Builder program, developed by ABCT member Mary Alvord. This program is a form of group therapy designed to help students who are struggling with both trauma and everyday anxiety caused by things like bullying or moving schools. By teaching social and emotional skills, Alvord argues that if students can learn this kind of resilience, they can better adapt to the world around them.
This Medical News Bulletin article reviewed a recent important study on mobile apps aimed to help children with anxiety. The study, published in Behavior Therapy, evaluated 121 apps found in Google Play and the Apple Store.
These apps targeted children with anxiety and their families, and were meant to enable families access mental health treatment techniques to help their children.
The study found that while most of these apps were free or low-cost, few of them contained evidence-based treatment components, with only 1/5 utilizing any form of exposure, one of the most integral parts of CBT for child anxiety.
The author of the article discusses the utility of these apps along with or independent of standard CBT treatment, and also reflects on the challenges facing those teams trying to create these kinds of mental health related apps.
With technology becoming an increasingly prevalent aspect of healthcare, it is important to stay up-to-date with these developments and understand how apps such as the ones reviewed in the cited study can help or hinder treatment.
A copy-right protected version of the article appears in Behavior Therapy; you can read the abstract, or if you or your institution is already a subscriber,
see the full article here
This recent New York Times article discusses Mariah Carey's recent disclosure regarding her struggles with mental illness.
Carey was diagnosed with Bipolar II Disorder in 2001, in the midst of an extremely successful career, but kept her mental health struggles a secret until recently because of her fears that stigma would end her career.
The last year has seen a wave of celebrities disclosing their personal mental health battles, inspiring others to follow suit in an effort to stomp out the stigma of mental illness.
For individuals struggling with bipolar disorder, characterized by extreme mood swings ranging from mania to extreme depression, accurate and timely diagnosis as well as both CBT and psycho-pharmaceutical interventions are critical to best care practices.
Disclosures from celebrities like Mariah Carey help to increase awareness and can encourage individuals who are suffering to seek help.
In addition to making an effort to destigmatize mental illness, ABCT also has a "Find a Therapist" page with an extensive list of therapists and their areas of expertise to help those who are beginning the journey toward mental health and wellness.
Junot DÍaz, an award-winning author, opens up about his long struggle with the experience of childhood trauma
He describes how his experience of childhood sexual assualt led to severe depression, suicidal behaviors, and difficulties in relationships for decades. He finally was able to begin removing the “mask” of trauma with the help of a dedicated therapist.
Cognitive-behavioral therapy for PTSD can help individuals recover after a traumatic experience. Learn more about PTSD and its treatment by visiting the VA’s National Center for PTSD website
"Courage is what we display when we face our fears and anxieties and take the risks of tackling the challenge despite those feelings."
Philip Eil describes his own experience with, as well as treatment for, anxiety. He describes anxiety as "a kind of ingenious, shape-shifting villain that knows the things I care about, and attacks them," and how Exposure Therapy helped him cope better by facing his fears.
For information on how to choose a therapist, click here
Warning Signs in Kids
A new study warns that kids who self-harm are at a much higher risk for suicide.
Violent self-harm may even be the indication of a failed attempt. However, the lead author of the study points out that forms of CBT, especially DBT, or dialectical behavior therapy, can teach kids positive coping skills, thereby reducing risk.
There's a great review of a scientific paper that explains the mechanism by which therapists help those suffering from OCD confront it and, one hopes, reduce its hold.
They explain "exposure" and how it works, which is requiring the person to confront precisely what he, or she, has been working so hard to avoid.
Exposure is done in a controlled way, so, for instance, a person with a snake phobia isn't thrown, a la Indiana Jones, into a pit of pythons.
For those interested in learning more about OCD, see
And to find a CBT therapist to help guide you to a freer life, see
Campus Mental Health
Recent surveys a have identified a significant increase in college mental health problems, according to a recent article published in Time Magazine. In a 2015 report, The Center for Collegiate Mental Health noted a 30% increase in college students seeking mental health services on campus, and according to a survey conducted by the American College Health Association, this past year saw a definitive increase in college students’ symptoms of depression, suicadality, and anxiety. This important article highlights a rising mental health crisis in a vulnerable population, and discusses several proposed solutions, including the work of past ABCT president Anne Marie Albano.
Teens will get as much from this article as their parents, as the Washington Post explores various notions of popularity, ways to think about, its cost, and even some of the effects later in life. Not surprisingly, ABCT members feature prominently in this article on parenting and problem solving.
In "The Day I Realized I Couldn't Handle My Anxiety Alone," Author Andrea Peterson discusses the difference between feeling worried and having anxiety eat away at your life. She experiences physical symptoms of anxiety and worried thoughts. Through a combination of Cognitive Behavior Therapy, medication, and exercise, she gets her life back on track.
To read the original article, click here
For more information about Anxiety Disorders, see the following fact sheet
For information on what to expect from Cognitive Behavior Therapy, click here
NBA player Kevin Love opens up about having a panic attack in the middle of a basketball game, and his search for treatment. Read the full article here
Panic attacks are defined as a sudden rush of intense fear or dread, which usually goes along with several physical symptoms and thoughts. Panic attacks can be treated through a variety of Cognitive Behavioral Therapy techniques.
Country star Lindi Ortega talks about her experience with Body Dysmorphic Disorder (BDD) in a personal piece about her struggles with this condition related to OCD, the effects of social media, and how facing the condition, therapy and exposing herself to be in the spotlight has was been transformative.
Read the full article here
BDD is condition related to OCD, characterized by intrusive thoughts and unwanted preoccupations with imagined or slight defect in appearance. BDD can be treated with CBT techniques.
To read more about OCD and related conditions like, BDD and treatment, see the following fact sheet
Online cognitive bias modification
The internet offers a promising way to deliver therapeutic skills with lower barriers than in traditional clinic-based practice. Bethany Teachman describes a new program developed by her lab that seeks to train individuals to have more healthy (nonthreatening) interpretations of ambiguous stimuli. Individuals are presented with short scenarios via their computer, phone, or tablet; the descriptions include an ambiguous element that is resolved at the end of the description. The individual completes a word fragment in the scenario to “cement” the positive interpretation, then completes a comprehension question.
Internet-based programs such as this one, as well as more comprehensive programs ( see ) may help to provide critical, evidence-based skills to the millions of people worldwide who suffer from psychological disorders.
Teachman’s group is actively testing their interpretation training programs to help determine how the training works and for whom; participation is available at: https://mindtrails.virginia.edu
Fighting anxiety doesn't always mean trying to relax. ABCT members Simon Rego and Mary Alvord speak to Real Simple magazine about why the classic advice to "just relax" when you're anxious doesn't work.
They discuss how to use effective techniques to fight anxiety and stress without calming yourself down, including facing your anxiety head on, and redefining relaxation in a way that speaks to you.
For more information on depression, see ; to learn more about what therapy is see
You can also scan some of our recommended self-help books on depression, including
Parenting, CBT, and the Anxious Child
The Wall Street Journal and New York Times feature the role of CBT in treating childhood anxiety.
The Wall Street Journal talks to CBT experts Anne Marie Albano, Eli Lebowitz, Andrea Chronis-Tuscano, and Jill Eherenreich-May about the role of parenting in maintaining and treating childhood anxiety. They discuss the role of helping parents reduce problematic behaviors related to their child's anxiety, while teaching parents to deal with their own feelings.
The New York Times highlights CBT as an effective treatment for childhood anxiety. They talk to ABCT member Stephen Whiteside about his metanalysis published in JAMA comparing CBT to medication. "The most helpful form of therapy, Dr. Whiteside said, according to the evidence, is exposure-based cognitive behavioral therapy, which involves helping kids face their fears in a supportive environment."
Past President of ABCT, Stefan Hofmann, describes how to tackle social anxiety: "put people in their worst-case scenario, where they are guaranteed to be repeatedly rejected... .
“No one is going to fire you or divorce you or arrest you if you do these things,” Hofmann explains. He compares himself to a neurotic movie director who helps script very specific scenarios for patients, getting straight to the core of their greatest social fear.
The treatment is dramatically effective: an 80% response rate.
To read more For more on social anxiety, see To learn more about what to expect from psychology, see For a list of CBT therapists who deal with social anxiety and other concerns, see Find a CBT Therapist
More ZZZZsConsumer Reports, in its February issue of this year, the "Sleep Issue," covered various fixes for sleep problems. Most sleeping pills fared poorly in doing what they're prescribed to do, and come with all kinds of side effects, including auto accidents whose rates match those driving under the influence. But CBT has none of those side effects, provides more sleep time, on average, than the pills, and can even be used to wean you off those pills if you want a longer sleep and clearer morning.
The Wall Street Journal reported that doing therapy in the morning, taking a nap afterward or adding a medication that enhances learning are just a few of the methods scientists use to make cognitive behavioral therapy work better.
Professor Michelle G. Craske at UCLA is the recipient of the 2017 the Society for a Science of Clinical Psychology (SSCP) Distinguished Scientist Award. This award is made to individuals who have made an extremely important career contribution to the science of clinical psychology and represents the highest award that SSCP can give. Michelle is the immediate past-president of ABCT, a former president of SSCP, and chaired the Anxiety Disorders subgroup for DSM-5. She is an acknowledged leader in the psychopathology and treatment of the anxiety disorders and in recent years has extended her work to depression as well. She is without question one of the best and the brightest in the field and we are honored to make this presentation.
New study finds that, When added to medication management visits, CBT interventions improve the therapeutic alliance, reduce stigma associated with psychosis, build skills to self-monitor and manage symptoms, reduce reliance on medication, and promote recovery.These interventions reinforce skills learned by patients Psychiatrists will find the extra few minutes spent with the patient to be personally enriching and professionally satisfying while improving outcomes and satisfaction for patients and their families. http://www.psychiatrictimes.com/special-reports/brief-cognitive-behavioral-therapy-interventions-psychosis.
A new preventative antidrug program identifies the traits that put children and adolescents at risk for addiction. Teachers and students are taught CBT skills to cope with the underlying emotional issues related to increased risk of addiction. The New York Times article explores the traits and how they are often not the ones that seem apparent. Read more:
Photo courtesy Faisal Akram, Dhaka, Bangladesh
BT for Sleep
Behavior Therapy was shown to be a better first choice for help in reducing sleeplessness than pills. The results and details can be found in an article in Psychiatric News
Oil on canvas, "Peanut Butter, The Binges," by Maria Raquel Cochez
Binge-eating disorder can be treated with talk therapy or drugs
Reuters followed up on a meta-analysis published in the Annals of Internal Medicine, and reported that a research team led by Kimberly Brownley of the University of North Caroline at Chapel Hill conducted a meta-analysis of studies using CBT, second-generation antidepressants and the amphetamine, lisdexamfetamine (Vyvanse) for treatment of binge-eating disorder, all of which have been deemed effective. Researchers highlight the success of CBT in changing the associated thoughts and resulting behaviors of binge-eating disorders.
Fox 55 in Springfield, Illinois urges its audience members who are stressed about the job search process to consider CBT. The article discusses the importance of challenging thoughts that could lead to anxiety and depression which can in turn result in maladaptive behaviors that interfere with the job search process (e.g., avoidance). Frustration/distress intolerance, global ratings of worth, and catastrophizing are cited as the primary culprits. "Talk Therapy" Helps Job Hunters. for more information on stress, see a full range of books that might help at our self-help book directory, including this one on stress, http://www.abct.org/SHBooks/?shTab=1&action=11&vBookID=236, or this on overcoming worry, http://www.abct.org/SHBooks/?shTab=1&action=11&vBookID=204, and see our fact sheet on stress: http://abct.org/docs/Members/FactSheets/ANXIETY.pdf.
Therapuetic Approaches for Insomnia
Psychiatric Times discusses a therapeutic approach that combines elements of common treatment approaches for bipolar disorder. Referred to as CBT-IB (cognitive-behavior therapy for insomnia & bipolar disorders), this approach combines elements of CBT for insomnia, social rhythm therapy, chronotherapy, and motivational interviewing. To break it down, this therapy incorporates sleep hygiene, regular sleep and wake routines, integration of therapeutic light and darkness to address circadian rhythms. The article acknowledges the limited research dedicated to this combined approach, but is still worth a read. CBT-IB: A Bipolar-Specific, All-Around Psychotherapy. For more on insomnia and how sleep is affected, see our excellent fact sheet on Circadian Rhythms: http://www.abct.org/Information/?m=mInformation&fa=fs_SLEEP_CIRCADIAN
Gerald Patterson, in Memoriam
Gerald Roy Patterson left us on August 22nd, 2016, surrounded by his family. Jerry was born in North Dakota to a family that worked on the railroad and in the iron mines; he grew up in northern Minnesota, where his love for nature developed. After receiving his doctorate from the University of Minnesota, Dr. Patterson became one of the first investigators to develop empirical measurements of family interactions and propose and test new theories and evidence-based treatments for troubled families with that data.
Dr. Patterson's many awards include a Presidential Citation and the Distinguished Scientist Award from the American Psychological Association, the Outstanding Achievement Award from the University of Minnesota, an honorary doctorate from the University of Norway, a Lifetime Achievement Award from the International Society for Research in Aggression, and a Merit award from the National Institute of Mental Health for excellence in research.
ABCT and APA past president Dr. Alan Kazdin said, "... Gerald R. Patterson's contributions to psychology include widely-cited coercion theory, early leadership in the behavior therapy movement, ground-breaking and paradigmatic research on aggression and antisocial behavior, and the development and empirical testing of parent management training."
He is the founder of the Oregon Social Learning Center in Eugene, where he continued to work until the last. He has devoted more than 40 years to the study of processes that disrupt family functioning and the development of "coercion theory," a data-based schema that explains these processes.
His books on parenting, "Families, Living with Children" and "Parents and Adolescents" have been read by millions. He has published over 200 hundred peer-reviewed articles, dozens of book chapters, and books on parenting, the outdoors, as well as poetry.
Jerry is survived by his wife, Marion Forgatch; his five children; and five grandchildren.
Three things I learned about anxiety by giving a TED talk about anxiety
Steve Hayes shares his experience, and his pain, while showing his TED talk
Suicide Rates Increasing
NPR features an article that highlights increasing suicide rates. Their article focuses on troubling increasing rates, especially heartbreaking among adolescent girls.
It also points to the need to increase access to services for youth of all ages and socio-economic strata.
And it speaks to screening for early intervention and prevention, which is not something that we do regularly, consistently, or comprehensively in the US. It speaks to the continued stigmatization of persons with mental health problems that prevent them from seeking help.
And, it speak to the lack of evidence-based treatments, like CBT and DBT, being available in the community.
To see the article
CBT for ADHD Getting More Play
The implications of treating kids with ADHD with CBT first is getting lots of play in more specialty conduits well beyond CBT's traditional reach.
The topic got lots of play when Ben Carey of the New York Times highlighted a pair articles that demonstrated the utility of CBT in treating ADHD.
What's fascinating is that other areas, like a site dedicated to kids with learning disorders, has picked it up:
The blog ends with this cutting remark: ï¿½I think this is a very important study, and the take-home is that low-cost behavioral treatment is very effective,ï¿½ said Mark Stein, a professor of psychiatry and pediatrics at the University of Washington, ï¿½but the irony is that that option is seldom available to parents.ï¿½
CBT Reduces ADHD Effects...
The New York Times' Benedict Carey talks about several studies investigating CBT's effects on ADHD symptom outcomes.
He writes that those students who began treatment with CBT all had better outcomes, regardless of the types of treatment used later on.
Further, he found that by using CBT as a treatment approach in the beginning, treatment costs were reduced annually by an average of $700, when factoring in direct and indirect costs.
To see the article, click here
Get Some Sleep
CBT for Insomnia (CBT-I) has been shown to be at least as good as, and sometimes better than, medication in fighting insomnia.
Read why, and how. Then sleep on it
Stefan Hofmann provides insights into Social Anxiety, its relative commonness, and techniques CBT therapists might use to help sufferers confront it effectively
Depression rates are holding steady and suicide rates are decreasing, so why do folks think Millennials are more prone to both?
Mitch Prinstein and others join NPR in exploring this
Patients with multiple sclerosis suffering from fatigue can benefit from an online CBT-based fatigue management program. Other benefits from the program include improvements in anxiety and subjective cognitive impairment.
Dr. Richard Friedman, a well-known psychiatrist in New York, recently published an Op-Ed article in the New York Times, which made a strong case for increasing federal funding for research on psychotherapeutic interventions.
The New York Times' article, covering a replication study of Paxil's effects is in stark contrast to CBT's long-term effectiveness in treating depression, its long-lasting positive effects, and its absence of negative side-effects.
To learn more about what questions you might ask the therapist, see
Examining Emotion in Procrastination
An article in the Wall Street Journal discusses the role of emotion in procrastination. Impulsivity and poor negative emotion tolerance may be just as important as poor time management strategies in facilitating procrastination. Exposing procrastinators to stressful feelings or thoughts is linked to decreased procrastination
BT Helps Insomnia
Cognitive Behavior Therapy shown to reduce insomnia symptoms and sleep disturbance in individuals with co-existing psychiatric symptoms: here
Huffington Post discusses how online therapy may bring down barriers to therapy and help bring therapy to those who otherwise couldn't, or wouldn't, use it.
An online CBT program may help those clients who normally wouldn't receive treatment due to financial constraints or those with limited access to therapists:
CBT for Panic
What's the best way to treat panic?
CBT according to an article in the Journal of Clinical Psychiatry. The next best thing is staying in treatment.
Many of us look at college as a new adventure, and as a way to leave the past behind, but, not surprisingly, who we are tends to follow us.
Join Anne Marie Albano as she gives us ideas for helping in smooth transitions
Being Black and Anxious
A recent Longest Shortest Time podcast from NPR featured a young mother discussing her anxiety in relation to her pregnancy, her young infant, and more. In addition, she worries about what she calls being the "model minority."
And like all great pieces on anxiety, ABCT is listed as one of the resources. Photo from NPR
For more on anxiety, see
and for those looking for a CBT therapist to help with anxiety or other issues, see
After The Crash
The recent Metro-North crash reminds us the trauma that passengers, family, and even onlookers, such as those waiting in their cars at the crossing, experience in the aftermath of a horrendous tragedy.
For some, the trauma is now; others may experience difficulties later, suffering from the delayed symptoms common in PTSD sufferers.
No, it's not confined to soldiers at war; not even confined to those hurt.
For information on PTSD and Trauma, please see our Fact Sheets.
For those who might want to talk to a CBT therapist, please see our Find a CBT Therapist directory.
A new NPR program, Invisibilia, explores some of how thoughts work, and how they become maladaptive. Alix and Lulu then look at how CBT and some third wave treatments approach maladaptive thinking, centering on one person's fear he was going to kill his wife.
Eating healthy is great, but when the quality and composition of meals becomes a time consuming preoccupation interfering with daily functioning of causing malnutrition, we may be dealing with orthorexia, a type of eating disorder, fortunately, this disorder appear to respond well to CBT approaches that are typically used for eating disorders and obsessive compulsive disorder.
Prolonged grief disorder (PGD) is a potentially disabling condition that affects approximately 10% of those who lose a loved one.
New research (link ) shows that cognitive behavior therapy (CBT) that includes exposure therapy to promote emotional processing of memories of the death is superior to CBT alone in reducing PGD severity.
How much do you really know about obsessive-compulsive disorder (OCD)?
OCD is often misconstrued or made light of in the popular media. In truth, it is a chronic condition that affects 2-3% of the U.S. population and is associated with marked functional impairment and quality of life deficits.
Fortunately, treatments such as cognitive behavior therapy and certain medications have been found effective.
Look at coverage in the New York Times, [link ],
or, for more information on OCD, see
Internet-CBT equal to face-to-face group CBT for chronic tinnitus
Chronic tinnitus (a condition that causes ringing or buzzing in the ears) can be debilitating.
A new study [link ]
compared fact-to-face group CBT with Internet-delivered CBT and found that both groups showed equally large improvements in measures of tinnitus severity and interference relative to waitlist control.
CBT Trumps Medications for Social Anxiety Disorder
A huge meta-analysis (link ) of 101 studies with more than 13,000 social anxiety disorder participants found that CBT had larger effect sizes than medications and other talk therapies.
The authorsï¿½ conclusion? CBT "should be regarded as the best intervention for initial treatment".
For more information on shyness and social anxiety, see
Childhood trauma could lead to adult obesity
A new meta-analysis, [link ], including over 100,000 adults, finds that childhood abuse greatly increases the risk of developing obesity as an adult.
Results from a new study [link ] show that CBT for insomnia is effective for veterans with sleep disorders.
Moreover, CBT for insomnia lead improved symptoms of comorbid psychiatric disorders as well. For more information on sleep disorders, see
Most People Have Unwanted Thoughts, International Study Finds
What if I hit someone with my car?
What if I contracted HIV? What if I left the iron on and my house burns down? If you have ever had thoughts like this, youï¿½re not alone.
A new study [link ] finds that these kinds of unwanted, intrusive thoughts are actually quite common, even among people who donï¿½t have obsessive-compulsive disorder (OCD).
CBT greatly reduced anxiety in grade school children
Childhood anxiety is very common and has been found to increase the risk of mental health problems in adulthood. A new study [link ] found that CBT greatly reduced anxiety levels in schoolchildren ages nine to 10 years old. This finding is important because strategies that can effectively reduce anxiety early on have potential for decreasing the huge social and economic burden associated with anxiety disorders over the lifespan.
Learn more about childhood phobias, social anxiety, and school refusal:
[link 2 ]
CBT for conversion disorder reduces psychogenic nonepileptic seizures
Psychogenic nonepileptic seizures are a conversion disorder that affect up to 400,000 people in the US.
A new clinical trial [link ] found that CBT, with or without sertraline, led to a reduction in seizures
and an improvement in comorbid symptoms, such as depression and anxiety, in patients with psychogenic nonepileptic seizures.
Online Psychotherapy Gains Fans and Critiques
The demand for online psychotherapy is growing rapidly. Research on the efficacy of delivering treatment online and guidelines to protect patients and therapists are racing to catch up. NRPï¿½s morning edition covers the story.
60 Minutes gets an inside look at how two specific types of CBT (prolonged exposure and cognitive processing therapy) can help veterans suffering from PTSD.
Link: Learn more about Trauma: Learn more about PTSD:
Kids with OCD benefit from family-based exposure therapy
A new study found that family-based exposure and response prevention (EX/RP) was effective in reducing symptoms of obsessive-compulsive disorders (OCD)and improving daily functioning in young children between the ages of five and eight with OCD.
The results indicate that with appropriate parental support, even younger children can benefit from EX/RP:
The scars of childhood bullying are still evident 40 years later
New research shows
that the effects of childhood bullying are still evident nearly 40 years later. Individuals who were bullied during childhood had poorer physical and psychological health and were at an increased risk of depression, anxiety disorders, and suicidal thoughts.
Need Therapy? There's an app for that.
A quick look at the latest research from the intersection of CBT and mobile technology.
CBT Provides Lasting Benefits to Anxious Kids and Teens A recent study found that CBT (with and without a medication for anxiety) was an effective treatment for youth with moderate to severe anxiety disorders. Moreover, the benefits of treatment were maintained 6 months after treatment with the help of monthly booster sessions.
To read more, see ;
and for more information on childhood phobias and social anxiety, see this and
CBT Benefits Patients with Body Dysmorphic Disorder
Body Dysmorphic Disorder (BDD) is an under-recognized body-image disorder that affects an estimated 1.7 percent to 2.4 percent of the population. In an recent randomized-controlled trial, researchers found that CBT significantly improved patients' BDD symptoms and level of disability, and was associated with high levels of patient satisfaction.
To read more, see For additional help, we have many self-help books, including this one
Help For Chronic Pain
New Study Finds Mindfulness Effective For Chronic Pain
Prescription opioid medications are a leading treatment for chronic pain, which affects nearly one-third of Americans. Misuse of prescription painkillers can lead to addiction or overdose.
Now, new research published in the Journal of Consulting and Clinical Psychology shows that Mindfulness-Oriented Recovery Enhancement, or MORE, can significantly reduce pain and opioid
misuse in chronic pain patients.
To read more about the study, see to find out more about Chronic Pain, see
CBT helps cancer patients get a good nightï¿½s rest
Cancer patients often struggle with sleep problems. A new study at University of Pennsylvania Perelman School of Medicine found that mindfulness-based stress reduction and CBT for insomnia can help patients get a much-needed good nightï¿½s rest
for more information, see our fact sheet on insomnia
OCD patients show greater improvement with CBT than with medications
"OCD patients on serotonin reuptake inhibitors (SRIs) should be offered EX/RP before being offered an addition of antipsychotic medications, given the greater efficacy and safety of EX/RP. We hope that these data will impact clinical practice and help more patients with OCD achieve wellness."
Lead Author, Dr. Blair Simpson
To read more about OCD see To find a therapist to help you confront your OCD see
Seminal ADHD study is re-evaluated by its authors
ADHD, the second most prevalent diagnosis in children, has long been treated primarily through drugs, a treatment that was fueled, in part by the study, Multimodal Treatment Study of Children With A.D.H.D.
Now, according to the New York Times, the studyï¿½s authors are suggesting perhaps CBTï¿½s value was understated. Says one of the studyï¿½s authors, ï¿½I hope it didnï¿½t do irreparable damage. The people who pay the price in the end is the kids.
Thatï¿½s the biggest tragedy in all of this.ï¿½
To read the full Times article, see
and to read more about ADHD, see
"The Forgotten Patients"Forbes.com September 3, 2010
Roughly 35,000 Americans commit suicide each year; another 1.1 million make attempts; while 8 million have suicidal thoughts. But Forbes Magazine details a treatment approach, DBT, developed by one of our members, Marsha Linehan, that has changedï¿½and savedï¿½lives.
Read more ...
Long-time member Edna Foa is named TIME Magazine Time 100ï¿½ for her work in treating PTSD
In the second segment of Tips for Life, Bob Leahy, ABCTï¿½s President, offers tips to help bipolar sufferers deal with the financial repercussions, giving examples of techniques and strategies that work.
Serious depression afflicts 2 million teenagers each year and puts them at greater risk of suicide and depression throughout life. But Cognitive behavioral therapy can prevent teenagers from becoming clinically depressed, even if their parents are depressed, too.
Depression Leads to Misperceptions of Criticism from Spouses People who are feeling depressed or who are having marital problems often complain that their spouses are critical of them.
Read more ...
One Session Exposure Therapy May Work for Reducing Anxiety One-Session Treatment (OST) is a form of exposure therapy for the treatment of fears and phobias.
Read more ...
CBT plus Zoloft is "gold standard" treatment for child anxiety In the combined treatment group, 81 percent of children were much improved by three months, compared with 60 percent in the therapy-only group, 55 percent in the sertraline-only group, and 24 percent in the placebo group.
Read more ...
This New York Times article documents the radical shift in psychotherapeutic techniques that has taken place over the past 20 years. Traditional psychoanalysis and psychodynamic therapies have become "totally eclipsed by cognitive behavioral approaches."
The Washington Post calls CBT "the fastest growing and most rigorously studied kind of talk therapy, the subject of at least 325 clinical trials evaluating its efficacy in treating everything from depression to schizophreniaï¿½ one whose benefits can persist and enhance one's life."
Dr. Jonathan Grayson is a special guest on the Oprah Winfrey Show. Dr. Grayson, a leading OCD specialist, demonstrates the dramatic success of a CBT technique called exposure and response prevention (ERP) therapy with a group of 6 individuals attending "OCD Boot Camp."
Dr. David Tolin, director of the anxiety disorders center at the Institute of Living in Hartford, is featured in a New York Times story on compulsive hoarding. The article write that "cognitive behavioral therapy may help: a recent study of hoarders showed that six months' therapy resulted in a marked decline in clutter in the patient's living space."
At the conclusion of this radio program, Dr. Tolin compares the failures of traditional talk therapy to alleviate the "locked in" plight of compulsive hoarders to the delivery of results through in-house CBT treatment.
This article describes Dr. Melissa Norberg and Dr. David Tolin use of virtual reality simulations as a supplement to CBT treatment to help Iraq War veterans recover from PTSD. According to Dr. Tolin, "cognitive behavioral therapy holds the only hope of a lasting reduction of symptoms of PTSD."
Dr. Robert Leahy, director of the American Institute for Cognitive Therapy, and other CBT therapists appear on this special news program. People suffering from severe, even crippling anxiety are taught how to cope with their fears in a dramatically short amount of time.
Dr. Leahy shared some advice and insight from his book, "The Worry Cure: Seven Steps to Stop Worrying from Stopping You", with Early Show co-anchor Harry Smith. Dr. Leahy's book outlines CBT-based strategies to help people suffering from anxiety take back control of their lives:
This article recounts how an adolescent struggling with a lifelong panic disorder received "new hope" after beginning intensive CBT treatment at the Center for Anxiety and Related Disorders at Boston University.
In this recent article, Dr. Steven Hayes discusses Acceptance and Commitment Therapy (ACT), which is a form of CBT treatment that incorporates the ancient practice of Eastern mediation to alter fundamental psychological processes.
The New England Cable Network (NECN) recently reported on the preliminary success of a 4-year, federally funded study that aims to treat severe anxiety in as few as 5 sessions of CBT. The study, which is conducted by researchers at Boston University's Center for Anxiety and Related Disorders (CARD), uses talk therapy in conjunction with an experimental medication.
Depression Leads to Misperceptions of Criticism from Spouses
People who are feeling depressed or who are having marital problems often complain that their spouses are critical of them. Are these reports of excess criticism due to perceptual biases on the part of distressed spouses or are they relatively accurate reflections of genuinely hypercritical spouses? Results of this study suggest that people who are more depressed, or who are experiencing marital discord, over-perceive spousal criticism, while those who are not experiencing these difficulties under-perceive criticism. Over- versus under-perceiving of criticism was indexed relative to "actual" criticism, based on independent ratings of observed criticism and partner reports of intended criticism, during a videotaped couple interaction. Over- or under-perceiving biases accounted for a substantial proportion of perceived criticism. Interventions for depression or martial discord may benefit from not only reducing the amount of actual spousal criticism though communication training but also addressing cognitive biases toward over-perceiving comments as critical.
Smith, D.A., & Peterson, K.M. (2008). Overperception of spousal criticism in dysphoria and marital discord. Behavior Therapy, 39, 300-312.
CBT plus Zoloft is "gold standard" treatment for child anxiety
By LINDSEY TANNER, AP Medical Writer Lindsey Tanner, Ap Medical Writer - Thu Oct 30, 2:31 pm ET
CHICAGO - A popular antidepressant plus three months of psychotherapy dramatically helped children with anxiety disorders, the most common psychiatric illnesses in kids, the biggest study of its kind found.
The research also offers comfort to parents worried about putting their child on powerful drugs - therapy alone did a lot of good, too.
Combining the drug sertraline, available as a generic and under the brand name Zoloft, with therapy worked best. But each method alone also had big benefits, said Dr. John Walkup, lead author of the government-funded research. It's estimated that anxiety disorders affect as many as 20 percent of U.S. children and teens.
In many cases, symptoms almost disappeared in children previously so anxious that they wouldn't leave home, sleep alone, or hang out with friends, said Walkup, a Johns Hopkins Hospital psychiatrist.
"What we're saying is we've got three good treatments," he said.
Sertraline is among antidepressants linked with suicidal thoughts and behavior in children with depression.
In this study, only a handful of the more than 200 kids using it had suicide-related thoughts and there were no suicide attempts, Walkup said. Suicidal tendencies are more common in depression than in anxiety, he said.
Zoloft, mostly used to treat adult depression and anxiety, is approved for treating obsessive-compulsive disorder in kids, but not anxiety. Some doctors use it for that, however. And some smaller, less rigorous studies have suggested it and other antidepressants can help.
The new study, paid for by the National Institute of Mental Health, is the largest examining treatment of childhood anxiety disorders, said co-author Dr. John March of Duke University,
Dr. Thomas Insel, the institute's director, said the study provides strong evidence that combined treatment is "the gold standard," but that sertraline or therapy alone can be effective.
Dr. Sharon Hirsch, a University of Chicago psychiatrist not involved in the study, said it echoes benefits she's seen in her own young anxiety patients on both treatments. But she note that the study shows that therapy alone is also good news for parents who don't want to put their children on an antidepressant.
The study, published online in the New England Journal of Medicine, was scheduled for presentation Thursday at an American Academy of Child and Adolescent Psychiatry meeting in Chicago.
Several study authors reported receiving consulting fees or other compensation from drug companies, including antidepressant makers.
The study involved 488 children aged 7 to 17 treated at six centers around the country. They were randomly assigned to one of four 12-week treatments: up to 200 milligrams daily of sertraline; 14 hour-long sessions of psychotherapy alone; both treatments together; or dummy pills.
In the combined treatment group, 81 percent of children were much improved by three months, compared with 60 percent in the therapy-only group, 55 percent in the sertraline-only group, and 24 percent in the placebo group.
Improvement, measured on a psychiatric scale, meant that anxiety had lessened so much that kids could do things they'd refused to do before, such as sleep in their own beds, go to school and socialize.
There was only one serious "adverse event" considered possibly linked to treatment - worsening behavior in a child on drug treatment only.
While many kids have occasional fears or anxiousness, those with full-fledged anxiety disorders are almost paralyzed by these feelings. Three types of disorders were studied: separation anxiety, generalized anxiety and social phobia, Walkup said.
Affected kids may be so worried that something bad will happen to their parents that they repeatedly refuse to go to school. Or they'll be so afraid of thunderstorms that they get chronic stomachaches, even when it's not stormy. Those with social anxiety disorder may just seem shy, but they are so self-conscious that they won't seek out friends or take part in class so their grades suffer, Walkup said.
"These kids were really miserable at the start of the study," and many ended up "really happy," March said.
The therapy used in the study was cognitive behavior therapy, which emphasizes that thoughts can be irrational and cause troubling feelings. It encourages patients to focus on positive thinking that allows them to develop ways of confronting fearful situations.
One Session Exposure Therapy May Work for Reducing Anxiety
One-Session Treatment (OST) is a form of exposure therapy for the treatment of fears and phobias. Through a collaboration between the patient and therapist, OST combines exposure, participant modeling, cognitive challenges, and reinforcement into a single session, maximized to three hours. Clients are gradually exposed to feared objects or situations with the therapistï¿½s guidance and support through ï¿½behavioral experimentsï¿½ which progress at a gradual pace. A number of studies on OST exist; however, little has been done to summarize this research. In this review, the empirical support for OST is reviewed with an emphasis on the types of stimuli, samples, and methodologies utilized. Research generally supports OSTï¿½s efficacy, although replication by independent examiners using adult and child samples is needed as is the use of more rigorous comparison groups. Overall, OST continues to be a promising treatment for specific phobias; however, a great deal more investigation is needed.
Zlomke, K., & Davis, T. E. (2008). One session treatment of specific phobias: A detailed description and review of treatment efficacy. Behavior Therapy, 39, 207-223.
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