Psychological treatments

Effective treatment for anxiety and depression

Cognitive behaviour therapy (CBT) is a structured psychological treatment which recognises that the way we think (cognition) and act (behaviour) affects the way we feel. CBT involves working with a professional (therapist) to identify thought and behaviour patterns that are either making you more likely to develop anxiety or depression, or stopping you from getting better. Once you've recognised any unhelpful patterns that are contributing to your anxiety or depression, you can make changes to replace these with new ones that improve your mood and coping skills.

For example, you might find yourself stuck in catastrophising thinking patterns. This means thinking the worst, believing something is far worse than it actually is, or anticipating things will go wrong. CBT helps by teaching you to think more realistically and focus on positive problem-solving. If you actively avoid situations or things that cause anxiety, CBT can help you face your fears and approach these situations more rationally.

Professionals may use a range of techniques in CBT. Examples include:

• evaluating how realistic your thoughts are by looking at evidence for or against them
• teaching you how to  solve any problems you’re facing.
• teaching relaxation and breathing techniques, particularly muscle relaxation, to control anxiety and the physical symptoms of tension.

Effective treatment for anxiety and depression

While behaviour therapy is a major component of cognitive behaviour therapy (CBT), unlike CBT it doesn’t attempt to change your thoughts or beliefs directly. Instead it focuses on encouraging activities that are rewarding, pleasant or give you a sense of satisfaction, in an effort to reverse the patterns of avoidance, withdrawal and worry that make anxiety and depression worse.

Behaviour therapy can be useful if anxiety is getting in the way of you doing certain things. Avoiding frightening situations can mean you don’t get a chance to face your fear and prove to yourself you can cope with it, in turn causing your anxiety to persist. Behaviour therapy for anxiety relies mainly on a treatment called 'graded exposure'. There are a number of different approaches to exposure therapy, but they're all based on exposing you to the specific things that make you anxious. This experience helps you cope with fearful situations rather than avoiding or escaping them, as well as putting your worry about the situation into perspective.

Effective treatment for depression

Interpersonal psychotherapy (IPT) is based on the idea that relationship problems can have a significant effect on our wellbeing, and can contribute to someone developing depression. On the flip side, supportive, happy relationships are good for our mental health. IPT helps you recognise patterns in your relationships that make you more vulnerable to depression. Identifying these patterns means you can focus on improving relationships, coping with grief and resolving issues and conflict.

Family therapy helps family members and close friends to learn about anxiety or depression. It helps people find new ways to support and get along with the family member who has anxiety or depression.

They can do this by:

• assisting their loved one with some of his/her daily responsibilities
• helping to identify stressful situations at home or work
• helping to find other ways to solve practical and emotional problems
• keeping an eye out for changes in symptoms.

Effective treatment for anxiety and depression

Acceptance and commitment therapy (ACT) is based on cognitive behaviour therapy. However, it does not teach people how to change their thinking and behaviour. Rather, ACT teaches them to ‘just notice’ and accept their thoughts and feelings, especially unpleasant ones that they might normally avoid. This is because ACT believes it is unhelpful to try to control or change distressing thoughts or feelings when depressed. In this way it is similar to mindfulness-based cognitive therapy ACT usually involves individual meetings with a therapist but can also be done in groups or online.

As an evidence-based type of psychotherapy, ACT helps you accept the difficulties that come with life. The three main areas associated with ACT are:

• Accept your reactions and be mindfully present
• Choose a direction in line with values
• Take effective action.

ACT is thought to work by helping people to stop avoiding difficult experiences, especially by ‘over thinking’ these experiences. Over thinking occurs when people focus on the ‘verbal commentary’ in their mind rather than the experiences themselves. ACT encourages people to accept their reactions and to experience them without trying to change them. Once people have done this, they are then encouraged to choose a way to respond to situations that is consistent with their values, and to put those choices into action.

Effective treatment for anxiety and depression

Dialectical behaviour therapy (DBT) is a type of psychotherapy that focuses on behavioural change for individuals with extreme emotions and distress. It is a modified form of cognitive behaviour therapy that was designed to treat borderline personality disorder, and more recently has been used to treat other mental health conditions including PTSD. In addition to CBT strategies, DBT teaches skills to reduce harmful actions and improve positive coping.

The term ‘dialectical’ means working with opposites. DBT uses opposing strategies of ‘acceptance’ and ‘change’. Acceptance skills include mindfulness and distress tolerance. Change skills include managing emotions and communicating effectively. These skills are delivered within a group setting for skills training, such as one on one individual skills therapy with an intensively trained DBT therapist.

Effective treatment for anxiety 

Solution-focused therapy (SFT) is a brief therapy that helps people focus on solutions rather than their problems. SFT uses people’s strengths and resources to help them make positive change. This may be useful for people with anxiety if their symptoms are related to specific situations or problems.