Treating anxiety and stress disorders with therapy

When anxiety is linked to a medical condition or substance use, treatment typically focuses on addressing the underlying cause. However, for other types of anxiety disorders, there are three main therapeutic approaches: psychotherapy, medication, and complementary treatments.

Psychotherapy — particularly cognitive behavioral therapy (CBT), exposure therapy, or insight-oriented therapy — plays a key role in helping people manage anxiety. Each of these approaches involves working with a mental health professional to understand the root causes of anxiety and learn strategies to control symptoms. Therapy can take place in various settings, from doctors' offices to schools, and it is most effective when you feel a strong connection with your therapist.

Cognitive behavioral therapy (CBT)

CBT, the leading form of psychotherapy for anxiety, aims to correct ingrained patterns of negative thoughts and behaviors. As the name suggests, the treatment has two parts. Cognitive therapy helps people change patterns of thinking that prevent them from overcoming their fears. Behavioral therapy works to change their reactions in situations that trigger anxiety. People with social anxiety disorder, for example, may assume that others will inevitably regard what they say as stupid. This is negative thinking. As a result, these people may avoid being with or talking to others. This is an example of negative behavior. The goal of CBT is to break this chain of thoughts and reactions.

Exposure therapy

Exposure and response prevention, a type of exposure therapy used to treat anxiety, gradually and increasingly exposes you to the object of your anxiety until the fear subsides. Under the guidance of a therapist, you first imagine and then confront your fears.

Studies show that a series of eight to 12 sessions of exposure therapy yields significant, long-lasting results: symptoms improve in 60% to 80% of people, and the benefits continue for two to six years. Today, virtual reality exposure therapy (VRET) is being explored as a way of treating PTSD, social anxiety disorder, and panic disorder.

Insight-oriented psychotherapy

This form of traditional talk therapy delves into how life events, desires, and past and current relationships affect your feelings, lead to discomfort, and contribute to your anxiety. During treatment, you and your therapist will discover the unconscious reasons behind your anxiety. Together, you'll explore how unresolved conflicts from your past may contribute to your present distress. The goal is to increase your self-awareness, as well as your acceptance of certain feelings or thoughts that may otherwise create discomfort or internal conflict.

For more information on therapy or other treatments for anxiety, check out Coping with Anxiety and Stress Disorders, a Special Health Report from Harvard Medical School.

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