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Treating Specific Anxiety Disorders and Depression with CBT

Panic Disorder without Agoraphobia: This is characterized by sudden episodes of intense fear as well as a fear of having these panic attacks. Treatment outcome studies show that around 80% of people become panic free within eight sessions of cognitive-behavior therapy with lasting results.

Panic Disorder with Agoraphobia: This is characterized by intense fear and avoidance of situations where escape is difficult or help unavailable if a panic attacks occurs. Exposure therapy is absolutely essential for agoraphobia, and it works extremely well if followed through with. Exposure can be gradual or intensive with intensive nongraduated exposure usually giving the fastest and best results. At Boston University's Center for Anxiety and Related Disorders 80% of people have no more agoraphobia avoidance after a four day program of intensive exposure therapy.

Specific Phobias: These are intense fears of specific objects or situations such as heights, blood-injury, claustrophobia, animals, fear of vomiting, and others. These are treated very effectively with exposure therapy. Some phobias have been overcome in as little as one or two therapy sessions.  I have a videotape of Paul Salkovskis, an internationally known cognitive-behavior therapist at Oxford University treating a lady with a severe phobia of feathers that, due to her fear of seeing a bird outside, had confined her to her house. Her phobia had lasted for 37 years and was completely overcome after 45 minutes of exposure therapy to feathers.

Social Phobia: These are intense fears of embarrassment, disapproval, or humiliation. They may be highly specific such as a fear of public speaking or more generalized such as anxiety in many or most social situations. These are best treated with a combination of cognitive therapy and exposure therapy.

Obsessive-Compulsive Disorder: This is characterized by troubling obsessive thoughts and ritual like compulsions. A form of cognitive-behavior therapy called exposure and response prevention is the most effective treatment for this disorder. 

Generalized Anxiety Disorder: This involves persistent anxiety and worry with the person not always aware of the source of their anxiety. This is best treated by finding the specific source of the anxiety and overcoming it through corrective learning as well as cognitive restructuring of the worry process itself.

Posttraumatic Stress Disorder: This is a reaction to an extreme traumatic stressor usually involving the threat of loss of life and is characterized by a symptom pattern of re-experiencing the trauma such as through intrusive thoughts, images, and nightmares. Cognitive-behavior therapy has been validated as a highly effective treatment for this disorder.

Depression: Cognitive therapy has been validated in numerous studies as a highly effective treatment for depression.  It does as well or better than medication and appears to be superior at preventing future relapse.

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