CBT interventions for GAD are delivered in diverse formats centered on cognitive restructuring, behavioral techniques, or their integration. Individual CBT remains the traditional approach, involving one-on-one sessions where therapists help patients identify anxiety-related negative thought patterns like catastrophizing, combined with behavioral strategies such as relaxation training and exposure therapy. Group CBT convenes multiple patients under therapist guidance to learn skills like anxiety diary keeping and cognitive disputation, leveraging peer support to boost compliance while cutting costs. Computerized CBT (cCBT) delivers structured content via apps or software, offering guided cognitive exercises and progressive muscle relaxation for patients lacking in-person resources or preferring self-directed care. Some interventions combine CBT with antidepressants like SSRIs, targeting both cognitive patterns and physiological symptoms in moderate-to-severe GAD cases.
Key Findings from the Systematic Review of Randomized Controlled Trials (RCTs)
Systematic reviews integrating RCT data show CBT yields significant short-term benefits for GAD, with patients demonstrating 50%-70% reductions in anxiety scores (via scales like GAD-7 or HAM-A) after 8-12 weeks compared to placebo or waitlist controls. Long-term follow-ups (6-12 months) reveal lower relapse rates in CBT groups versus medication-only cohorts, highlighting its durability through cognitive pattern modification. While individual and group CBT show comparable efficacy, cCBT proves similarly effective for mild-to-moderate cases while enhancing accessibility.
Core Conclusions of Network Meta-analysis (NMA)
Network meta-analysis, by comparing relative intervention efficacies, provides a comprehensive framework to evaluate how CBT forms stack up against pharmacological treatments, placebo, or other psychotherapies. Early analyses suggest CBT may outperform medication in sustained symptom reduction, though specific modality rankings (e.g., individual vs. cCBT) depend on patient characteristics like comorbidity or technological access. These findings inform evidence-based guidelines for tailoring GAD interventions to individual needs, while highlighting gaps for future research on long-term outcomes and cost-effectiveness across delivery formats.
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