Does therapy help with anxiety?

Introduction: Researchers tested whether a single, long therapy session could reduce intense fear of spiders.

Participants: 48 adults (38 women and 10 men) aged 18 to 52 in a city in Norway, each diagnosed by a clinician with a specific phobia of spiders. Race/ethnicity was not reported.

Method: Participants were randomly assigned to one 3-hour session or to a waitlist group. In the session, a therapist guided each person through a series of steps, ranked from least to most frightening: looking at photos of spiders, watching a live spider in a closed jar, touching the jar, and eventually letting a small spider walk on their hand. The therapist moved to the next step only after the person's fear had dropped. Fear was measured with a 12-step approach test, in which participants moved step by step closer to a live spider in an open tank; the score was the number of steps completed (0 to 12).

Results and Discussion: The treatment group's mean score rose from 3.1 steps before treatment to 10.2 steps afterward. The waitlist group's mean rose from 3.4 to 3.9 steps over the same period. One year later, 80% of the treatment group could still complete at least 10 steps.

Introduction: Researchers tested a skills program for teenagers with social anxiety disorder.

Participants: 86 teens aged 13 to 17 (55 girls and 31 boys) who had been diagnosed with social anxiety disorder by clinicians at two outpatient clinics in Australia. Parents gave consent and teens gave assent.

Method: Teens were randomly assigned to one of two programs, each with 12 weekly 90-minute sessions held in groups of six. In the skills program, teens learned to notice anxious thoughts (such as 'Everyone will think I'm weird if I speak'), question them and replace them with more realistic ones, and then practiced feared situations, such as giving a short talk or ordering food. In the comparison program, teens met with a counselor and talked about their week, without learning these skills. After 12 weeks, clinicians who did not know which program each teen had attended interviewed every teen.

Results and Discussion: After 12 weeks, 58% of teens in the skills program no longer met the criteria for social anxiety disorder, compared with 28% in the comparison program, a statistically significant difference. Teens in both programs said they valued meeting others with similar experiences.

Introduction: Researchers examined whether the relationship between a client and a therapist predicts how much clients improve.

Participants: 312 adults receiving outpatient therapy for anxiety at 14 community clinics in the United States. Clients received one of three common types of therapy.

Method: After their third session, clients rated their working relationship with their therapist (for example, 'My therapist and I agree on what I am working toward' and 'I feel my therapist cares about me') on a scale from 12 to 84. Anxiety symptoms were measured at the start of therapy and again after 16 weeks.

Results and Discussion: Clients' ratings of the working relationship were positively correlated with how much their anxiety symptoms decreased (r = +0.29), no matter which type of therapy they received. Overall, 61% of clients showed meaningful improvement in their symptoms after 16 weeks.