Cognitive therapy vs behaviour therapy in the treatment of chronic general anxiety

Abstract

Psychiatric outpatients with a diagnosis of chronic anxiety of at least one year's duration were randomly assigned to either behaviour therapy or Beck's cognitive therapy, and to one of two experienced therapists. Both treatment conditions followed the therapeutic processes described in Beck's treatment manual for anxiety states, but the behaviour therapy condition excluded any attempt to modify automatic thoughts, thinking errors, or underlying assumptions. However, it did include the use of positive self-statements. Treatment consisted of a maximum of 16 1-hour sessions. Several outcome measures were administered before treatment, during treatment, at discharge, and at 6 month follow-up. At the end of treatment there was no difference between the cognitive and behavioural treatments in the amount of improvement observed. By the 6 month follow-up, however, there was a trend, which was significant on a number of outcome measures, for the cognitive therapy patients to maintain or improve upon their progress and for the behaviour therapy patients to revert toward their pre-treatment scores.