4 types of therapy for anxiety

Research over many years can now give us a picture into the most effective treatments for anxiety disorders such as generalized anxiety disorder, social anxiety disorder, specific phobias, and panic disorder.

1. Cognitive behavioral therapy (CBT)

CBT is the most well-researched and strongly supported treatment for anxiety disorders. The cognitive part of the treatment helps people identify unhelpful thoughts that fuel their anxiety and avoidance. They learn to examine these thoughts and develop a more balanced perspective, which can reduce the intensity of anxiety and any related physical sensations, as well as shift behaviors that would have otherwise maintained the anxiety. 

One component of CBT, specifically when it comes to phobias and avoidance, is called exposure therapy. This is where a therapist helps a client face their fears in a structured, repeated way so that it reduces the fear response over time. With the guidance of a licensed therapist and a client's full consent, there is strong evidence that exposure therapy can effectively help clients manage and even overcome specific fears.

Overall, CBT is widely recommended for anxiety treatment by organizations like the Mayo Clinic and the American Academy of Family Physicians. CBT is best for individuals who want structure, homework activities, and concrete tools. 

2. Acceptance and commitment therapy (ACT)

Many research trials have shown ACT to be similarly effective to CBT for treating anxiety. ACT helps people with anxiety to notice and accept their anxious thoughts and then take actions guided by their values regardless of the fear. This allows them to increase flexibility in their thinking and take steps towards what they truly want in life rather than avoidance. It is useful for someone who resonates with a more mindfulness and values-based approach.

3. Mindfulness-based cognitive therapy (MBCT)

MBCT also shows evidence as a helpful anxiety treatment. Clients are taught mindfulness meditation in combination with CBT skills. They observe their internal experiences (thoughts, emotions, and sensations) without judgment or reacting to those experiences. It helps people with anxiety learn that anxious thoughts are just mental events and not facts, which can reduce ongoing worry. It is useful for someone who is drawn to developing a structured mindfulness practice.

4. Applied relaxation (AR)

AR, another cognitive-behavioral approach, helps people to recognize their first signs of anxiety and apply relaxation techniques as soon as possible. Skills, such as progressive muscle relaxation, are taught so that they can be applied and reduce the sensations of anxiety that can show up in the body. It targets responses in the nervous system that may show up in anxiety disorders. It’s particularly useful for generalized anxiety and worry‑related muscle tension. AR can benefit someone who wants concrete, body-focused tools and is willing to practice them regularly. 

It’s important to note that there are other forms of treatment that have shown some signs of usefulness for anxiety treatment. However, the research base has mixed results or is too small to make formal recommendations. This article highlights the therapy options that have the strongest and most proven research basis.