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From catastrophic thinking to calibrated response — structured cognitive-behavioral therapy
Cognitive-behavioral therapy (CBT) is the first-line psychotherapy for generalized anxiety disorder, social anxiety, panic disorder, and specific phobias. At Dr. Ruja's clinic, treatment begins with a functional analysis of anxiety triggers, cognitive restructuring of maladaptive thoughts, and graduated exposure hierarchies. Unlike medication-only approaches, CBT addresses the maintaining factors — avoidance, safety behaviors, and catastrophic misappraisal — that perpetuate anxiety over time.
Kathmandu Neurology Clinic & Cognitive Center
Authored and reviewed by Dr. Ruja Shrestha (MBBS, MD (Psychiatry), NMC 19766). Evidence-based, no fabricated outcomes.
Cognitive-behavioral therapy (CBT) is the first-line psychotherapy for generalized anxiety disorder, social anxiety, panic disorder, and specific phobias. At Dr. Ruja's clinic, treatment begins with a functional analysis of anxiety triggers, cognitive restructuring of maladaptive thoughts, and graduated exposure hierarchies. Unlike medication-only approaches, CBT addresses the maintaining factors — avoidance, safety behaviors, and catastrophic misappraisal — that perpetuate anxiety over time.
Reviewed by Dr. Ruja Shrestha, MBBS, MD — Consultant Psychiatrist & CBT Therapist (NMC 19766), Kathmandu Neurology Clinic. For evaluation, book an appointment.
Anxiety disorders are maintained by three interlocking processes: biased threat perception (overestimating danger), avoidance of feared situations, and underestimation of coping capacity. CBT systematically disrupts each. The therapist collaborates with the patient to identify automatic negative thoughts, test their validity through behavioral experiments, and replace avoidance with approach behaviors that disconfirm feared outcomes.
CBT for anxiety typically runs 12–16 sessions with homework between sessions. Response rates range from 50–75% depending on disorder severity and comorbidity. The clinic emphasizes measurement-based care using GAD-7, PHQ-9, and disorder-specific scales to track progress. When anxiety is severe or comorbid with depression, combined CBT and pharmacotherapy may be considered, though CBT alone is preferred for mild-to-moderate presentations.
Guidelines referenced:
Hofmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin PsychiatryNICE CG113 — Generalised anxiety disorder and panic disorder in adultsCraske MG, Barlow DH. Mastery of Your Anxiety and Panic. Oxford University PressContent on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.