Category: Anxiety

Dallas CBT offers cognitive behavioral therapy for separation anxiety. Separation anxiety in children results from significant fear and avoidance of situations where one is separated from a loved one. Therapy for separation anxiety teaches your child to decrease worry thoughts and to increase use of coping skills when separation occurs. Or treatment involves working closely with parents to ensure that new, healthier patterns are developed between sessions.

Separation Anxiety is characterized by intense and excessive fear when separated from the home or loved ones. Specifics of this fear can vary, and can include: excessive distress in anticipation of separating, worry about losing or being separated from important loved ones due to some unanticipated event (e.g., accident, kidnapping), refusal or reluctance to go to school or work, fear of being alone, refusal or reluctance to sleep away from home or a loved one, nightmares, and physical symptoms in response to separation. Understandably, this type of intense fear of separation can greatly impact one’s ability to function individually, as well as interfere with loved ones’ ability to function. In children, this may be noticeable as early as preschool, and can often result in a refusal to go to school.

Potential Signs of Separation Anxiety

• Significant worry that something bad will happen if separated from an important loved one (e.g., parent, significant other)
• School refusal, or refusal to leave a loved one
• Refusal to sleep separately from a loved one
• Significant fear of being alone

Treatment

Cognitive behavioral therapy for separation anxiety involves identifying and changing themes in problematic thoughts and behaviors that keep your child anxious. Number of therapy sessions vary, but on average, substantial progress is seen in 12-15 sessions.

In therapy, your child will learn to identify and alter anxiety-provoking thoughts, build and improve upon coping skills, reduce avoidance, and improve the ability of both the child and the parents to separate in a healthy, adaptive, and supportive manner.

Dallas CBT’s specialized treatment for GAD involves cognitive behavioral therapy that includes acceptance and mindfulness-based components. This approach is considered the most effective therapy for generalized anxiety. Our treatment teaches how thoughts, feelings, and behaviors interact to cause anxiety, and helps you to change problematic worry and thought patterns and re-engage with meaningful and helpful behaviors.

What is Generalized Anxiety Disorder (GAD)?

Generalized anxiety disorder (GAD) involves persistent anxiety and worry about a broad range of situations, from everyday issues to global disasters. These worries can take up a lot of time and can be very difficult to control or disconnect from. Though the subject of worry is often related to “everyday” concerns (e.g., finances, tardiness, grades, safety) that we all worry about at times, GAD worries are often excessive (e.g., worrying your loved one has been in a horrible accident if they are 10 minutes late) and can make it difficult to get work done or be present at school, work, or home. Further, those struggling with GAD often experience persistent physical symptoms of anxiety, including: muscle tension, restlessness, fatigue, concentration difficulties, irritability, and sleep disturbance.

Potential Signs of GAD

• Near-constant worry or anxiety about a variety of things
• Others describe you as “a worrier”
• Frequently thinking or worrying about the “worst case scenario”
• Often feeling tense or on edge
• Finding it difficult to story or control your worrying
• Difficulty concentrating or relaxing
• Physical symptoms such as neck pain and tension, stomach aches, and headaches
• Irritability

Our Treatment Approach

Dallas CBT provides cognitive behavioral therapy for generalized anxiety that involves retraining your brain to engage in different thinking and behavior patterns. Our treatment involves CBT and aspects of ACT (Acceptance and Commitment Therapy), which are the most scientifically-supported therapies for generalized anxiety. The length of treatment for GAD ranges depending on the individual’s concerns, but significant progress is often seen across several months.  In therapy, you will learn to: identify unhelpful patterns of thinking, learn to respond to thoughts differently and to disengage from anxious thinking (e.g., “looping” or catastrophizing), increase behaviors in line with your values and goals, an increase your ability to relax and cope day-to-day.

Dallas Health Anxiety Therapists

Dallas CBT specializes in treatment for Health Anxiety (aka hypochondriasis, illness anxiety, or somatic symptom disorder) in children and adults. Our bodies are “noisy” and at times, unusual physical symptoms might raise concern about whether a medical condition is responsible. In health anxiety, or hypochondriasis, one can become preoccupied with internal sensations, such as a pain, stomach ache, or changes in heart rate, and assume that they are signs of serious illness despite medical reassurance. Harmless but uncomfortable bodily sensations can become alarming and stressful, causing fear that starts to dominate day-to-day living. Worrying about health can take on an obsessive quality and lead to monitoring of symptoms and multiple doctors visits, which themselves can become quite costly. Struggling with these concerns can lead to significant avoidance of activities, situations, and objects that might provoke certain physical sensations and anxiety about these symptoms.

Potential Signs of Health or Illness Anxiety

• Irrational and excessive concern that one has a serious illness
• Engaging in bodily “checking,” such as taking temperature, monitoring blood pressure or heart rate, and scanning the body for symptoms
• Preoccupation with bodily sensations
• Spending a large amount of time searching the internet for information on symptoms
• Multiple doctors visits
• Frequently seeking reassurance from others
• Avoiding objects (e.g., medical shows, articles) or situations (e.g., exercise, caffeine) that increase anxiety or are believed to make the condition worse

Treatment

Cognitive behavioral treatment for health anxiety has shown to be effective and successful within a relatively short number of sessions. Our evidence-based treatment program for health anxiety involves cognitive-behavioral and exposure techniques. Treatment will generally consist of 12 to 20 sessions, although this varies dependent on each client’s needs.

Exposure therapy and other cognitive behavioral techniques are especially effective for treating health anxiety or hypochondriasis. These approaches involve reducing health-related obsessive thinking through cognitive restructuring, where one learns to challenge the validity of distorted thoughts, and gradual exposure to fearful thoughts, sensations, and situations. Through exposure, one learns that feared consequences are unlikely to come true and that anxiety decreases naturally over time and, after repeated exposure, will stay down. In vivo (real life) exposures, imaginal exposures, which involves imagining a feared situation, and interoceptive exposures, which involves confronting feared bodily sensations, play an important role in therapy. The overarching goal of this therapy is to reduce fear and distressing thoughts and decrease avoidance of objectively safe thoughts and situations. This treatment may cause short-term anxiety, given that you’ll be facing the fears that you have been avoiding; however, it is the most effective way to gain long-term freedom from anxiety.

Treatment is tailored to each individual, with their own experiences and specific concerns influencing each component of treatment.  In therapy, you can expect to: better understand what causes and maintains health anxiety, learn to change unhelpful responses to anxiety-provoking thoughts, increase tolerance for uncertainty and/or physiological symptoms, and reduce the impact of feared health concerns through systematic exposure to anxiety-provoking thoughts, situations, and bodily sensations.

Dallas CBT specializes in exposure therapy, the most effective approach to treating fears and phobias, for children and adults. The techniques used in this form of therapy work effectively across a wide range of feared objects or situations, from fear of dogs to claustrophobia to flying phobias. Typically, we see a significant reduction in fear or anxiety relatively quickly, ranging from just a few sessions to 10 sessions. Goals for treatment include reducing or eliminating the fear and increasing tolerance and ability to be near the object, such as a dog or spider, or in the feared situation, such as a thunderstorm or elevator. A more detailed explanation of the therapy is below.

What is a Phobia?

We all have certain objects or situations that we are at least a little afraid of, whether it’s the huge dog down the street, flying, climbing a rickety ladder, or that time a spider was in the shower. When these fears become very intense and begin to affect our day-to-day functioning, they may be diagnosed as a Specific Phobia. There are a broad range of potential phobias which can be grouped into those involving animals (e.g., dogs, snakes), natural environments (e.g., heights, water), situations (e.g., flying, elevators), or medical treatments (e.g., fear of shots, blood).

Potential Signs of a Phobia

• Intense fear or anxiety about a specific thing or situation that others seem to handle fairly easily
• The fear is out of proportion with the actual danger posed by it
• Strong physical sensations, like a racing heart, heavy breathing, sweating, trembling or upset stomach when you’re thinking about or actually exposed to the feared object or situation
• Going out of your way to avoid the feared object or situation, or experiencing great distress when exposed to it

Treatments For Specific Phobias

Treatments for Specific Phobias are some of the most effective and successful programs available. We offer evidence-based and effective treatment programs for a wide variety of specific phobias. Phobias can be treated within a few sessions, with the average being 5 to 10 sessions of exposure-based therapy. Treatment length varies dependent on each client’s specific needs.

Exposure therapy is a type of CBT that is highly effective for anxiety-related disorders, such as specific phobias. In fact, it is referred to as the “gold-standard” of psychological treatments for these issues. Exposure involves gradually and systematically confronting fears, with the support and expertise of your therapist, that you have been avoiding or enduring with significant distress. Exposure allows you to learn that feared consequences are unlikely to come true and that your anxiety will go down naturally over time– and will stay down after repeated exposure. There are two main types of exposures in treatment for specific phobias: imaginal, where you are asked to imagine a feared situation, and most importantly, in vivo, or real life exposure. The overall goal of exposure therapy is to reduce or eliminate avoidance of objectively safe objects or situations, which leads to reduction in anxiety and fear about these situations. Although exposure therapy causes short-term anxiety by having you face your fears, it is the most effective way to gain freedom from phobias.

In exposure therapy, you can expect to: learn about causes of phobias and factors maintaining it, change problematic behaviors, especially avoidance, regain control of behaviors through gradually and systematically confronting fears , and identify the role that thoughts play in the anxiety process while learning to frame thoughts differently.  Treatment is customized to each client, with their specific anxiety and experiences influencing the content of each treatment component.

Panic Attack & Panic Disorder Treatment in Dallas

Dallas CBT specializes in cognitive behavioral therapy, which is a gold-standard treatment for children and adults with panic disorder and panic attacks. Whether you recently started experiencing panic attack symptoms or you have been living with panic attacks for years, CBT-based panic attack treatment can help reduce the cycle of fear and avoidance. Typical goals include reducing panic attacks, decreasing fear about panic, building coping skills for stressful situations, improving mood and overall anxiety, and supporting a more fulfilling life. Read more about therapy for panic disorder below.

What Is Panic Disorder and How Is It Different From a Panic Attack?

Panic attacks are experienced as a rush of fear and physical symptoms, such as a racing heart, chest tightness, trembling, and sweating, and an intense urge to escape or avoid. It can feel like a heart attack (though it isn’t) and cause people to worry that they are going to die, lose control, or “go crazy” (though they aren’t).  Panic Disorder sufferers experience repeated attacks and frequent worry about when the next attack might happen. These attacks can occur either “out-of-the-blue,” or in response to specific situations. People with panic disorder might start avoiding places where an attack could occur, like a mall, concert, or driving a car.

Panic Attack Symptoms & Signs of Panic Disorder

• Repeated, unexpected panic or anxiety attacks which feel like an abrupt surge of intense fear or discomfort
• Strong physical sensations like a racing heart, heavy breathing, difficulty breathing, tightness or heaviness in chest, sweating, trembling or upset stomach that occurs all at once
• Trips to the hospital, doctor, or cardiologist for attacks, with no identifiable medical or physical problem
• Worry about “losing control” or “going crazy”
• Nervousness around situations that might prompt an attack, like driving, shopping, closed or small spaces, or being in a crowd
• Spending time worrying and thinking about attacks and when you might have another attack

Panic Attack Treatment For Panic Disorder

Cognitive behavioral therapy utilizing exposure techniques, also known as “panic control treatment,” is a scientifically-supported treatment for Panic Disorder that reduces symptoms and improves functioning usually within 15 to 20 sessions.

Components of the treatment include 1) Education aimed at understanding the cycle of panic and how negative thoughts and physical sensations interact to maintain anxiety and panic, 2) Breathing skills training to increase coping during a panic attack, 3) Cognitive restructuring, or “thinking skills,” and 4) Gradual and systematic exposure. The cognitive components of this therapy approach are effective in reducing negative or catastrophic interpretations of physical sensations of anxiety that fuel the cycle of intense anxiety leading to attacks. Exposures, which involve gradually facing fearful stimuli, provide the opportunity to desensitize to anxiety-provoking bodily sensations, situations, or thoughts. Through exposure, one learns that feared consequences are unlikely to happen and that anxiety will decrease naturally over time, and anxiety will stay down after repeated exposure. Interoceptive exposures, which involve facing anxiety-provoking bodily sensations, are critical to decreasing sensitivity to physical symptoms and allowing for more rational and helpful interpretations of these sensations. In vivo exposures involve gradually and therapeutically confronting real-world situations that cause anxiety and are avoided (often in an effort to decrease chances of a panic attack). The overarching goal of this therapy is to reduce anxiety, panic, and distressing thoughts and to decrease avoidance of objectively safe bodily sensations, thoughts and situations. This treatment may cause short-term anxiety, given that you’ll be confronting fears, but it is the most efficient way to overcome anxiety in the long-term.

Treatment is customized for each individual, with personal experiences and concerns influencing each aspect of treatment.

Schedule an appointment with Dallas CBT today!

Dallas CBT serves as the regional clinic for the National Social Anxiety Center (NSAC). NSAC strives to make high-quality and evidence-based services available to those living with social anxiety through research, collaboration, and educating clinicians and the public. Visit NSAC here for more education and resources on Social Anxiety Disorder.

Dallas CBT specializes in exposure therapy, which is the gold-standard cognitive behavioral treatment for social anxiety in children and adults. Treatment is offered both in individual and group formats, with significant progress often seen around 15-20 sessions. Typical goals for treatment include feeling less anxious around others, increasing social activities, establishing friendships or romantic relationships, improving mood and, overall, living a more fulfilling life. More detailed information about the therapy is below.

What is Social Anxiety?

Experiencing anxiety in social or performance situations is quite common; in fact, public speaking is often at the top of most peoples’ lists of feared situations. However, social anxiety disorder is more than discomfort around others or shyness. Social anxiety is a strong fear of being judged or embarrassed in front of others, despite a desire to be social. This fear can manifest in everyday social situations, situations where one is being observed (e.g., eating, writing), or performance situations (e.g., giving a speech), to name a few. Social anxiety makes it extremely difficult to go to school or work, meet new people, or even talk to the cashier at the store, which can lead individuals with social anxiety to avoid social situations as much as possible.

Potential Signs of Social Anxiety

• Frequent worry of being embarrassed, humiliated, or seen negatively
• Strong physical sensations like a racing heart, heavy breathing, blushing, sweating, trembling or upset stomach when in social situations
• Replaying social interactions over and over in your head
• Avoidance or serious distress around activities that involve other people such as parties, meetings at work, talking to authorities, or speaking in front of others
• Worrying for days or weeks leading up to a social event
• In children, these symptoms may manifest in crying, tantrums, freezing, clinging, or failing to speak in social situations
• These symptoms have persisted for several months or more

Effective Social Anxiety Treatment at Dallas CBT

Dallas CBT offers both individual exposure therapy for children and adults, as well as state-of-the-art group exposure therapy programs for social anxiety. Exposure therapy is a type of cognitive behavioral treatment (CBT) that is the most effective for anxiety disorders. In fact, it is often referred to as the “gold-standard” of psychological treatments for these issues. Exposure involves gradually and systematically confronting fears and anxiety-provoking situations that you have been avoiding, with the aid and support of your therapist. Exposure provides the opportunity to learn that feared consequences are unlikely to come true and that your anxiety will go down naturally over time– and after repeated exposure, it will stay down. Exposures can be conducted as imaginal, where you are asked to imagine a feared situation, in vivo, or real life exposure, and interoceptive, which involves confronting feared bodily sensations. The overarching goal of exposure therapy is to reduce or eliminate avoidance of objectively safe situations, which leads to reduction in anxiety about these situations. Although this treatment causes short-term anxiety, as it involves facing the fears that you have been avoiding, it is the most effective way to gain long-term freedom from anxiety.

Our social anxiety group treatment program is a 12-16 week structured treatment that meets for ~2-hour sessions weekly. Group therapy offers an effective way to confront feared social situations and improve social skills in a supportive environment, in real time. Group therapy is often our recommended course of treatment for individuals with social anxiety; however, we also offer individual therapy for these issues. Individual CBT for Social Anxiety typically involves weekly 50-minute or 90-minute sessions, across 15-20 weeks. However, the length of the program can vary according to the individual’s needs.

In exposure therapy, you can expect to: learn about what causes and maintains social anxiety, identify the role that thoughts play in the anxiety process, learn to frame problematic thoughts differently, and build tolerance of feared social situations through gradual and systematic exposure to situations that provoke anxiety.  Treatment is tailored to each client, with their specific type of anxiety and their own experiences influencing the content of each component of treatment.