15.8 ANXIETY DISORDERS: PSYCHOLOGICAL TREATMENTS Kaplan & Sadock’s Comprehensive Textbook of Psychiatry CHAPTER 15. ANXIETY DISORDERS 15.8 ANXIETY DISORDERS: PSYCHOLOGICAL TREATMENTS

Since the late 1980s there has been tremendous progress in the nonpharmacological treatment of anxiety disorders. Cognitive-behavioral therapies, which reflect a recent integration of the cognitive theories and methods associated with Aaron Beck, Albert Ellis, and David Clark, and the behavioral theories and methods of B.F. Skinner and Ivan Pavlov, currently have the greatest degree of empirical validation. Panic disorder, which has been said to be the most disabling of the anxiety disorders in terms of social and occupational functioning is a case in point in that recently developed treatments contain elements based on classical or Pavlovian conditioning, behavioral techniques of exposure, and cognitive restructuring of irrational beliefs and overvalued ideas. Other anxiety disorders for which cognitivebehavioral approaches have been particularly effective include social phobia (both generalized and nongeneralized type), obsessive-compulsive disorder, specific phobia, social phobia, and generalized anxiety disorder. Further validation is needed for two recently developed treatments for posttraumatic stress disorder, one based on exposure methods, and the other based on classical conditioning (eye movement desensitization and reprocessing [EMD/R]). Psychosocial (e.g., supportive and psychodynamic) therapies have also been used in the treatment of anxiety disorders.