Cognitive-Behavioral Therapy: Goals and Treatment Timeline
If you undergo cognitive-behavioral therapy or behavioral therapy, exposure will be carried out only when you are ready; it will be done gradually and only with your permission. You will work with the therapist to determine how much you can handle and at what pace you can proceed.
A major aim of cognitive-behavioral therapy and behavioral therapy is to reduce anxiety by eliminating beliefs or behaviors that help to maintain the anxiety disorder. For example, avoidance of a feared object or situation prevents a person from learning that it is harmless. Similarly, performance of compulsive rituals in OCD gives some relief from anxiety and prevents the person from testing rational thoughts about danger, contamination, etc.
To be an effective anxiety treatment, cognitive-behavioral therapy or behavioral therapy must be directed at the person's specific anxieties. An approach that is effective for a person with a specific phobia about dogs is not going to help a person with OCD who has intrusive thoughts of harming loved ones. Even for a single disorder, such as OCD, it is necessary to tailor the therapy to the person's particular concerns.
Cognitive-behavioral therapy and behavioral therapy have no adverse side effects other than the temporary discomfort of increased anxiety, but the therapist must be well trained in the techniques of the treatment in order for it to work as desired. During treatment, the therapist probably will assign "homework" -- specific problems that the patient will need to work on between sessions.
Cognitive-behavioral therapy or behavioral therapy will generally last about 12 weeks. The therapy may be conducted in a group, provided the people in the group have sufficiently similar problems. Group therapy is particularly effective for people with social phobia. There is some evidence that, after anxiety treatment is terminated, the beneficial effects of cognitive-behavioral therapy last longer than those of medications for people with panic disorder. The same may be true for OCD, PTSD, and social phobia.
Medication may be combined with psychotherapy, and for many people this is the best approach to anxiety treatment. As stated earlier, it is important to give any anxiety treatment a fair trial. And if one approach doesn't work, the odds are that another one will, so don't give up.
If you have recovered from an anxiety disorder, and at a later date it recurs, don't consider yourself an "anxiety treatment failure." Recurrences can be treated effectively, just like an initial episode. In fact, the skills you learned in dealing with the initial episode can be helpful in coping with a setback.