Exposure-based cognitive behavior therapy (CBT) is strongly proven to treat anxiety, trauma, and mood. It has the most extensive research for generalized anxiety, obsessive compulsive disorder, social anxiety, panic, post-traumatic stress disorder, and depression. It falls under the umbrella of CBT with a focus on behavioral experiments to approach one’s fears and emotions.

Research shows that avoiding triggers and unwanted emotions can have a counterproductive effect. Trying to avoid these triggers strengthens and reinforces the unwanted emotions, such as anxiety and shame. These problematic avoidance behaviors also interfere with living life fully.

The goal of exposure therapy is to create new learning in fear-based situations. For example, learning that the probability of the feared outcomes is relatively low. It also involves understanding that the ability to cope is greater than predicted. Exposure therapy also allows for mastery over emotions, an ability to understand and regulate emotions.

Types of exposures:
1. Imaginal (exposure in one’s mind)
2. In-vivo (real life)
3. Interoceptive (to physical symptoms).

Examples of exposure based cognitive behavior therapy treatments:
1. Exposure response prevention (ERP) for OCD.
2. Prolonged exposure (PE) for trauma.
3. Behavior activation (BA) for depression.

Key components of CBT include:

1. Identify negative thought patterns.
2. Cognitive restructuring – replace irrational and problematic thoughts. Learn how to replace with more realistic and functional thoughts.
3. Behavior activation – actively changing behaviors. Increase pleasant events and mastery building behaviors, build routine, decrease unwanted behaviors.
4. Core belief work – increase new thoughts and behavior to challenge inaccurate beliefs that maintain anxiety and depression.
5. Skill building – problem solving, emotion regulation, mindfulness, and other effective tools to decrease symptoms.
6. Exposure therapy – gradually facing fears in a safe and controlled way.
7. Case conceptualization – collaborative efforts to map out problems to solve and behaviors to change. This assessment is necessary to structure skills and homework.
8. Homework – actively applying coping strategies outside of sessions.

Can I do CBT on my own: There are many CBT resources for mild symptoms. Self-help can be helpful for some. If symptoms are more moderate to severe and interfering in quality of life, it is recommended to seek professional help by a clinician with training and experience in CBT.