Online CBT for Anxiety: How does it Work?

Online CBT for Anxiety: How does it Work?

Anxiety might develop gradually and then suddenly become a part of your everyday life. You might find it hard to go about your day without experiencing anxious thoughts and feeling tense. If you leave it untreated, you might find yourself struggling to relax and handle your responsibilities. Luckily, there are many effective ways to treat anxiety, and one of them is online CBT therapy which became increasingly popular during the COVID-19 pandemic. In this blog, you’ll learn more about how online CBT for anxiety works and how it can benefit you.

Does Online CBT for Anxiety Work?

Because of the pandemic, online therapy has become the norm, but it’s likely here to stay because it turns out it works just as well as treatment in person.

CBT is one of the most effective treatments for various mental health problems. While online CBT recently gained increased popularity mainly because of COVID-19, its benefits were already well-documented. Previous research looked at the management of various mental disorders, including anxiety and panic disorder, and found that online CBT was an effective treatment method. [2]
Additionally, studies that compare the effectiveness of online versus face-to-face CBT find that they’re both equally beneficial for patients struggling with anxiety. [3]

What Are the Benefits of Online CBT?

When you deal with anxiety, it might be instinctual sometimes to use distractions to cope. Unfortunately, ignoring anxious thoughts only adds to the problem. Before you know it, you might be even distressed at the thought of leaving your house. This is when online CBT can be the most useful. You can receive treatment from the comfort of your home without worrying whether you can manage your anxiety enough to show at the appointment.

The benefits of online therapy include:

  • Convenience: talking to a therapist in a comfortable, safe environment at a time that’s most convenient to you. It’s a good option for people who are busy and don’t want to spend too much time getting to the appointments and back.
  • Accessibility: being able to access the help you need even if you live in a different city or if you have a disability and mobility issues.

In addition to these benefits, CBT will help you with:

  • Improved quality of life: an ability not to let the anxious thoughts take over
  • Reduced anxiety symptoms: you’ll no longer avoid anxiety-inducing situations and feel more like yourself again
  • Awareness of the causes of anxiety and how it affects your body and mind, reducing the chance anxiety will resurface in the future
  • Learning strategies you can use to manage and reduce negative thinking and regain confidence and agency in your life
  • Learning techniques to relax that will help reduce physical symptoms

Online CBT for Anxiety Sessions: How Do They Work And What Do They Focus On?

Cognitive Behavioural Therapy is an approach that focuses on the thoughts and beliefs you have about yourself and the world. The goal is to equip you with skills that can help you address the negative thinking that contributes to feelings of distress. CBT aims to teach you, among other things, how to confront and overcome your fear instead of ignoring it.

At the start or, and during an Online CBT for Anxiety session

At the start of your therapy session, your therapist will ask you to discuss your symptoms. Then you’ll agree on the goals to be achieved during therapy and structure each session depending on the issue you want to focus on. For example, if you experience anxiety before social events your therapist might devote one session (or more) to helping you identify the reasons for your distress and helping you understand how anxiety affects your body and thought process. 

Your CBT therapist might ask you to use a shared document to write down negative thoughts that arise before a stressful event and find evidence supporting these thoughts and evidence against them, which will help you develop more realistic thinking. If your fear is more specific, like a fear of flying or spiders, the main goal will be to gradually expose you to the feared stimuli. For example, your therapist might show you photos of planes or play videos recorded from inside a plane by using the ‘share your screen’ option. 

At the end of a session of an Online CBT for Anxiety

At the end of each session, your CBT therapist will typically give you homework that will be challenging enough but not overwhelming. This can be in a Word document and will be discussed at the beginning of the next session. For example, you might be asked to do journaling whenever you experience anxious thoughts that will help you identify harmful thinking patterns but also better understand what triggers your anxiety in the first place.

Sessions are usually tailored around the goals discussed at your first session. However, what happens in each session also depends on what’s going on in your life.  If there’s a specific issue you’d like to focus on in the next session, feel free to mention it to your therapist, who will adjust the goals and structure accordingly. Throughout the therapy, the CBT therapist will review your progress and typically set more challenging goals with you to get the most out of your sessions. Remember, you’re working as a team to reach your goals together!

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How Long Does Online CBT for Anxiety Last?

The approximate number of CBT therapy sessions for Anxiety is between 5 and 20, with each session usually lasting 50 minutes. However, the length of therapy will depend on your situation and symptoms. For example, you can expect good results for mild anxiety within 4-8 sessions, whereas if you’re coming with a long-standing issue that severely impacts your daily functioning, it may take longer, usually around 16-20 sessions. These are cases where your anxiety is considered to be severe or enduring.

How To Prepare For Online Sessions of CBT for Anxiety?

Opening up to someone you’ve never met before can be daunting. Additionally, if you have anxiety, you might worry about all the things that can go wrong: what if the camera doesn’t work? What if your flatmates come back from work early and interrupt your session? What if your kids or builder start making noises in the background?

Here are some measures you can take to prepare for the session better and decrease your anxiety:

1. Check your devices

To avoid unnecessary stress, make sure your camera and microphone work correctly. You can log into the teleconferencing programme and test them beforehand. You should also make sure your internet connection is fast enough to avoid interruptions. Additionally, decide if you’re going to be sitting at your desk or in your bed (it can be anywhere as long as you feel comfortable), and make sure the environment is tidy and free of distractions.

2. Let others know they shouldn’t disturb you

If you don’t live on your own, let your flatmates, partner or children know
You don’t have to tell them you’re going to have a therapy session but let them know you won’t be available during a specific time and ask them to keep the noise down.

3. Write down your worries

Writing down your worries will help you relieve some stress and make you feel more prepared for the session. You’ll know if there’s anything specific you want to mention to your therapist, and it will be easier to discuss what goals you want to achieve at the end of the therapy.

4. Try  “The miracle question.”

To have a clearer idea of what you would like to work on and what goal you would like to achieve, the miracle question is usually beneficial. Ask yourself, “If tomorrow I woke up and found out that my anxiety had gone, what would look different in my daily life?”. Try to answer as concretely as possible. Changes may be as small as “I would make time for breakfast with my partner in the morning” or “I would go for a walk in the park close to home at least 3 times a week”. They may also be more ambitious, such as “I would finally find the courage to ask for a promotion”. The more concrete your goals, the easier to attain them. Don’t forget to tell about your answer to the miracle question to your CBT therapist at your first session!

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Tips To Manage Anxiety In Between Sessions

Contrary to what some people might hope for, therapy isn’t a magical pill that will make you feel better without putting in the effort. While CBT is a great option also because it requires doing work in between sessions, it’s good to take additional steps to manage your anxiety. Here’s what you can do:

1. Include exercise in your routine

If you aren’t into fitness, including sports in your routine can seem like an impossible task, but you can always start small. For example, make sure you go for daily walks, even if it means another shopping trip to buy snacks. Try to focus on how being out in the fresh air makes you feel and stay in the present by concentrating on the landscape.

2. Get familiar with positive affirmations

Affirmations are statements you can repeat daily to increase positive thinking. For example, ‘’I’m going to have a great day today’’, ‘’I’m safe’’ or “Anxiety is not dangerous”, “Whatever happens I’ll deal with it!”.

3. Practise relaxation techniques

You’ll be taught relaxation techniques during your therapy, but you can look up some guided meditation online. Try typing ‘relaxation techniques’ on a YouTube search.

4. Cut back on social media use

Browsing social media often goes hand in hand with comparing yourself to other people and the fear of missing out. It has been negatively linked to wellbeing, so you’re better off using it less frequently. [4]


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Improving Anxiety Symptoms With The Help Of Online CBT Therapy

Living with anxiety can interfere with your daily responsibilities and prevent you from enjoying life to the fullest. Online therapy can equip you with coping skills and help you improve your thinking patterns.

At Therapy Central, we have qualified therapists that specialise in online CBT therapy.

Contact us for a free 15 min consultation to see if our help would fit your needs.

More readings :

What is anxiety? How to manage it?

CBT for Anxiety: Survival Guide

Does CBT For Anxiety Work?

What are Thinking Errors in CBT (and how to manage them)

What Happens In CBT For Anxiety?


Additional links:
Anxiety self-help tools

Guided meditation for anxiety



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