First-line treatment: a critical appraisal of cognitive behavioral therapy developments and alternatives

Psychiatr Clin North Am. 2009 Sep;32(3):525-47. doi: 10.1016/j.psc.2009.05.001.


In this article, the authors assess the successes, remaining challenges, and new developments in cognitive behavioral therapy (CBT) for anxiety disorders. They define CBT, examine treatment components, review treatment efficacy, and discuss the challenges of attrition, long-term follow-up, co-occurring/comorbid disorders, limited treatment comparisons, treatment mediators, and broader implementation. In addition, they present recent developments in cognitive behavioral therapy for anxiety disorders, including linking exposure therapy to basic science, mindfulness and acceptance-based treatments, and unified or transdiagnostic treatment protocols.

Publication types

  • Review

MeSH terms

  • Anxiety Disorders / complications
  • Anxiety Disorders / therapy*
  • Clinical Trials as Topic
  • Cognitive Behavioral Therapy / methods*
  • Cognitive Behavioral Therapy / trends*
  • Desensitization, Psychologic / methods
  • Follow-Up Studies
  • Humans
  • Mental Disorders / complications
  • Mental Disorders / therapy
  • Models, Psychological
  • Patient Compliance
  • Patient Dropouts
  • Relaxation Therapy / methods
  • Stress, Psychological / therapy
  • Treatment Outcome
  • Treatment Refusal