Question 1

What therapy works for anxiety and how do I choose?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 2

What is CBT for anxiety?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 3

How effective is CBT for anxiety disorders?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 4

What is exposure therapy and how does it work?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 5

Which CBT protocol should I use for each anxiety disorder?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 6

What are the alternatives to CBT for anxiety?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 7

Should I combine medication and therapy for anxiety?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 8

How does the CAMS trial guide pediatric treatment decisions?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 9

What is the inhibitory learning model?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 10

Do benzodiazepines interfere with exposure therapy?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 11

How do I find an evidence-based anxiety therapist?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

Question 12

What is the SPACE program for childhood anxiety?

Accepted Answer

CBT is the most studied psychotherapy for anxiety, with NNTs of 3-4 across disorders comparable to first-line medication. Exposure is the specific component most consistently associated with treatment effect — yet it appears in only ~1/3 of routine CBT sessions. The inhibitory learning model redefines the goal: expectancy violation, not anxiety reduction. Protocol selection matters: Clark and Wells for social anxiety, interoceptive exposure-based PCT for panic, One-Session Treatment for specific phobias, MCT or the Unified Protocol for GAD non-responders or complex comorbidity. ACT is a strong Tier 2 alternative. Pediatric protocols require developmental adaptation and targeted parental involvement (Contingency Management + Transfer of Control); SPACE demonstrates parent-only treatment is non-inferior to child CBT. Combined treatment (CAMS data) is most transformative for separation anxiety. Concurrent PRN benzodiazepine use is associated with poorer CBT outcomes.

PsychHQ

What Therapy Works for Anxiety and How Do I Choose?