Describe how a combination of cognitive-behavioral therapies might be used to treat an anxiety disorder.
Cognitive-behavioral therapy is a hybrid form of treatment that uses the tools and resources of both cognitive therapy and behavioral therapy. Cognitive therapy seeks to help the patient become more aware of his own cognitive processes and to correct false notions of himself and the world. Behavioral therapy challenges the patient to experience the world differently: he learns to handle challenging situations by invoking specific behaviors or by changing his habits.
Cognitive-behavioral therapists often use journaling, behavioral cueing and role-play when treating anxiety disorder. In journaling, the patient simply writes down all his thoughts, feelings and actions throughout the day. In sessions, he and his therapist might discuss his behavioral patterns and notice whether they are effective or not. Usually, the way the patient is attempting to deal with his anxiety is counterproductive. That is, the anxiety-resolving mechanism he employs actually produces more stress and anxiety. A good example is a person who overeats out of stress and anxiety, and then in turn becomes stressed out about overeating. Journaling often helps the patient to notice these patterns for himself.
Behavioral cueing is a method of developing new habits. The therapist may instruct the patient to do breathing exercises, visualization exercises, or merely to say a specific phrase when he's feeling anxious. Sometimes simply acknowledging anxiety reduces it. In the case of the overeater, the therapist may instruct: "Every time you open the refrigerator, ask yourself 'am I hungry, or am I trying to resolve my anxiety?'"
Finally, the therapist may use role place to help the patient practice making good choices. If a person experiences anxiety disorder and debilitating shyness around his social and professional superiors, the therapist may engage in role play in which he pretends to be the patient's boss. The patient can then practice asserting his needs in a positive and healthy manner. This practice makes it easier for the patient to control his anxiety when he is with his boss in real life.