Anxiety and Behavioral Health Services
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Cognitive-Behavioral Therapy (CBT)
CBT typically focuses primarily on thoughts, feelings, and issues
in the present and how to cope effectively. The “cognitive” portion
of the therapy refers to discussion of thoughts and how to challenge,
modify, or ignore unhelpful, upsetting thoughts. The behavioral
portion of the treatment addresses how a person’s activities
(or avoidance), interactions, and environment may be contributing
to distress. Treatment strategies include education about the nature
of thoughts, feelings, and body sensations; problem-solving; assertiveness
practice; acceptance of one’s feelings and experience; and
often something called “exposure with response prevention”
(see below).
CBT usually requires “homework” to be completed between
therapy sessions. The therapist and client work together to design
useful homework exercises for practice. Sometimes the treatment
involves reading or using a workbook in conjunction with the therapy
sessions.
Exposure with Response Prevention (ERP)
ERP is a strategy used to help a person “face fears.” Usually,
at ABHS, this involves constructing a hierarchy of situations or
experiences that trigger feelings of anxiety in the client.
Starting with the least anxiety-producing tasks, the client gradually
practices “facing” the
situation (that’s the “exposure”) and continuing
to face it until the anxiety goes away (that’s the “response
prevention"—not escaping the situation until the anxiety is
over). For example, someone with high social anxiety might practice
walking through a mall and making brief eye contact with strangers
at first, until this feels easy; later, s/he might practice starting
conversations with others. Someone having panic attacks might practice
driving in different settings, or doing exercises that produce
uncomfortable body sensations. The goal of such exposures is to
be able to stay in the situation until the anxiety is relieved (or
"extinguished"), teaching the brain that it no longer needs to set off
the "alarm system" in response to the situation.
