Cognitive behavioral therapy has benefits that go beyond just helping to reduce anxiety. It can also help with the symptoms of depression, for example, which may accompany generalized anxiety disorder. Because CBT involves directly confronting your fears, the therapy itself can sometimes be quite distressing. Generally speaking, the side effects of psychological treatments haven't been well studied.
In Germany, CBT is offered by behavioral therapists and covered by statutory health insurers. It typically involves weekly sessions over several weeks or months. Depending on the circumstances and the technological set-up, these kinds of sessions can also be held virtually, for example as a video call.
Cognitive behavioral therapy has two parts: a “cognitive” part that deals with thoughts and feelings, and one that deals with behavior.
The goal of the cognitive approach is to change thought patterns that trigger anxiety by learning to
- identify unrealistic anxieties and fears and challenge them,
- assess the actual likelihood and consequences of the things that trigger the anxiety, and
- cope with insecurities.
One example of thought patterns that can make you feel anxious is “catastrophizing” – immediately jumping to extreme and exaggerated conclusions about the extent of a possible threat as soon as anything unsettling happens. By detecting these kinds of thoughts with the help of a therapist, you can try to get rid of them or find a way to better cope with them. Overall, cognitive behavioral therapy helps you to be more aware of your thoughts and control them better.
The second part of the therapy involves slowly lowering your level of anxiety in certain situations and changing your behavior. The fear is confronted in order to gradually overcome it. For example, a working mother who constantly calls the kindergarten in order to check up on her child may try to gradually reduce the number of calls she places. To make it easier to change your behavior, the therapy also involves learning techniques to keep calm – like breathing exercises or relaxation techniques. You can also write down your feelings in a digital diary, for instance on a computer, tablet or cellphone. It's also possible to use a virtual guide to relaxation exercises at home, at a time that best fits your daily routine.