How Can Disputation Help Manage Social Anxiety?

Cognitive Behavioral Therapy for Social Anxiety Disorder | Society of Clinical Psychology

How Can Disputation Help Manage Social Anxiety?

2015 Criteria
(Tolin et al. Recommendation) Treatment pending re-evaluation 1998 Criteria
(Chambless et al.


  • Basic premise: thoughts, feelings and behaviors are inter-related, so altering one can help to alleviate problems in another
  • Essence of therapy: Cognitive therapy techniques focus on modifying the catastrophic thinking patterns and beliefs that social failure and rejection are ly; exposure therapies are designed to gradually encourage the individual to enter feared social situations and try to remain in those situations.
  • Length: approx. 12 sessions

Editors: Evan Forman, PhD; Joanna Kaye, BA

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Outlines

  • CBT for Social Anxiety Disorder Outline (Hofmann & Otto)

Self-help Books

Important Note: The books listed above are empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment.

We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

Smartphone Apps

  • iCBT (Bonfire Development Advisors)
  • AnxietyCoach (Mayo Clinic)

Important Note: The apps listed above are empirically-supported in-person treatments.

They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment.

We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

Video Demonstrations

Group CBT for SAD (Hofmann et al)

  • Introducing group members (Hofmann et al.)
  • Overview of group treatment (Hofmann et al.)
  • Establishing ground rules (Hofmann et al.)
  • Presenting social anxiety model (Hofmann et al.)
  • Assigning homework (Hofmann et al.)
  • Exposure rationale (Hofmann et al.)
  • Setting up speech exposure (Hofmann et al.)
  • Speech exposure (Hofmann et al.)
  • Post-processing speech exposure (Hofmann et al.)
  • Rationale for social cost exposures (Hofmann et al.)
  • Setting up in vivo exposure (Hofmann et al.)
  • In vivo exposure (Hofmann et al.)
  • Post-processing after in vivo exposure (Hofmann et al.)

Clinical Trials

  • Cognitive therapy versus fluoxetine in generalized social phobia (Clark et al., 2003)
  • Cognitive—behavioral therapy versus supportive therapy in social phobia (Cottraux et al., 2000)
  • Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia (Davidson et al., 2004)
  • Cognitive—behavioral group treatment for social phobia: Effectiveness at five-year followup (Heimberg et al., 1993)
  • Treatment of social phobia in cognitive-behavioral groups (Heimberg et al., 1994)
  • Cognitive behavioral group therapy versus phenelzine therapy for social phobia (Heimberg et al., 1998)
  • Cognitive mediation of treatment change in social phobia (Hofmann, 2004)
  • Cognitive therapy for social phobia: individual versus group treatment (Stangier et al., 2003)

Meta-analyses and Systematic Reviews

  • Psychological and pharmacological interventions for social anxiety disorder in adults: A systematic review and network meta-analysis (Mayo-Wilson et al., 2014)
  • Cognitive-behavioral and pharmacological treatment for social phobia: A meta-analysis (Gould et al., 1997)
  • Psychological treatment of social anxiety disorder: A meta-analysis (Acarturk et al., 2009)
  • Meta-analysis of cognitive-behavioral treatments for social phobia (Taylor, 1996)
  • Cognitive and behavioral treatments for anxiety disorders: A review of meta-analytic findings (Deacon & Abramowitz, 2005)
  • The treatment of social anxiety disorder (Rodebaugh, Holaway, & Heimberg, 2004)
  • Cognitive-behavioral therapy for social anxiety disorder: Current status and future directions (Heimberg, 2002)
  • Cognitive-behavioral therapy for social anxiety disorder: The state of the science (Gordon, Wong, & Heimberg)

Other Treatment Resources


Overcome Social Anxiety

How Can Disputation Help Manage Social Anxiety?

Everyone feels social discomfort of some kind, but for many people social anxiety can feel unbearable and crippling. Social anxiety is a problem that, if left unchecked, can lead to complete avoidance of potentially rewarding situations. Social withdrawal is also associated with depression.

Living in New York City demands that you interact with other New Yorkers whether you want to or not. Social phobia can make seemingly harmless interactions feel painful. I have developed a method for helping people overcome social anxiety.

Nervousness in social situations can be improved. Social anxiety therapy may just change your life.

Signs of Social Anxiety

While it’s debatable how helpful it is to label yourself as having a “disorder,” a diagnosis of Social Anxiety Disorder is the following criteria (as stated on the Social Anxiety Institute’s website):

A.  A persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.

B.  Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally pre-disposed Panic Attack.

C.  The person recognizes that this fear is unreasonable or excessive.

D.  The feared situations are avoided or else are endured with intense anxiety and distress.

E.  The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.

F.  The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months.

G. The fear or avoidance is not due to direct physiological effects of a substance (e.g., drugs, medications) or a general medical condition not better accounted for by another mental disorder.

Cognitive Behavioral Therapy for Social Anxiety That NYC Needs

You no longer have to feel you don’t know what to say in an unstructured social situation.

You don’t have to worry about how people are judging you when you’re socializing.

You need not worry about feeling the odd person out, you’re a fraud with something to hide.

I can help you feel prepared for new and ambiguous social situations.

I can assist you in social habits and patters that have brought you mental discomfort in the past.

I would the opportunity to help you to dispute irrational beliefs around who you are as a social being, what people might think of you and what the risks are.

I can help you to overcome depression associated with disappointing social experiences or avoidant behavior.

My enhanced cognitive behavioral therapy (CBT) approach is designed to give you the tools you need to feel more comfortable in your own skin in social settings.

Why Try Social Anxiety Treatment?

I have helped many New Yorkers to feel less socially anxious, which in turn, has made them experience less overall anxiety. People begin therapy saying, “Doctor, I have social anxiety.” They leave therapy after a group of sessions feeling they have a mental backpack of tools for managing anxiety before social situations and in moments of actual social contact.

Given how much time we spend with our heads buried in our screens, it has become that much more important to make sure you get quality face-to-face time with friends to counterbalance the negative effects of constant screen time.

Most importantly, enhanced social confidence from social anxiety treatment will open doors for you. You will find that your support network expands, that it’s easier to access help from friends when you’re struggling and that you spend less time worrying about upcoming social events.

I enjoy doing this work as a psychologist in New York. It’s powerful to watch people change the way they feel about their social self. There’s so much pressure in NYC to be a well-d extrovert. I help people free themselves of this outside pressure and to get in touch with their strengths and who they want to authentically be in the world.

Feel free to contact me with any questions about social anxiety treatment.


Rational Emotive Behavior Therapy (REBT) Reduces Anxiety

How Can Disputation Help Manage Social Anxiety?

I recently attended a rational emotive behavior therapy (REBT) training and I began thinking more about using it to reduce my own anxiety. Rational emotive behavior therapy, the first form of cognitive behavioral therapy (CBT), was developed by Albert Ellis in the 1950s. The REBT approach encourages us to dispute irrational thinking to develop healthy emotional self-regulation.

What Is Rational Emotive Behavior Therapy?

Rational emotive behavior therapy is a solution-focused model of psychotherapy. It’s the premise that our emotional responses result from our beliefs, rather than external circumstances.

If our underlying beliefs are irrational and self-defeating, we tend to suffer more emotional disturbances such as anger, shame, and anxiety.

In REBT, the therapist helps the client identify, dispute, and replace irrational beliefs.

Understanding the ABCs of REBT

Ellis developed an A-B-C model to help understand how irrational thinking causes emotional reactions. In this theory:

  • A = activating event (challenging situation)
  • B = beliefs (your appraisals and evaluations about the activating event)
  • C = consequences (emotional and/or behavioral)

Most people think that A causes C. We say to ourselves, “Public speaking (A) makes me anxious (C),” or, “His remarks (A) make my blood boil (C).” Yet, when we neglect B, we fail to recognize that it’s our interpretation of the events that cause C, not the events themselves.

Allow me to illustrate with an REBT ABC model example from my life in which irrational thoughts would lead to anxiety:

  • Activating event: Someone criticizes my yoga teaching.
  • Belief (irrational): I’m a horrible yoga teacher.
  • Consequence: I feel anxious and worthless.

In this example, I might be tempted to say, “I feel anxious (C) because I was criticized today (A).” But A does not cause C. I only feel anxious and worthless because of what I’m telling myself: “How dare I not be perfect? I’m so awful. It’s intolerable to experience criticism.”

REBT Says to Let Go of Irrational Beliefs

According to Ellis, our irrational beliefs are all variations of demands that we place on ourselves, others, or the world. They are:

  1. I must do well and win approval or I will be worthless.
  2. Others must act the way I want them to act and treat me fairly. If they don’t, they deserve to be punished and I’ll find them intolerable.
  3. The universe must give me what I want when I want it. I can’t stand not getting what I want.

How do we use REBT to change irrational thinking that causes anxiety?

An REBT Exercise to Reduce Anxiety

The following are questions to ask yourself to identify, dispute, and replace irrational beliefs. You'll notice the order of the A, B, and C are rearranged (some refer this to the ACBDE model of REBT). This helps us to get to the actual underlying belief.

  • A: What is the activating event that triggered a response?
  • C: What are the consequences? What are you feeling?
  • B: What are you telling yourself to make yourself feel that way? What demands are you making?
  • D: What is the evidence that this belief must be true? How can you prove it? What effect are you creating if you continue to make it true?
  • E: What do you prefer but not need in order to feel okay?

Here's an example of how one might walk through this process:

  • A: Neighbors making noise.
  • C: I feel angry and anxious.
  • B: They should know better than to make noise. It’s unbearable when they’re loud.
  • D: It’s not written in stone that they must be quiet. I have no proof that this is the right way to be. I don't even have proof that they know they're loud.
  • E: I’d prefer to have quiet neighbors, but I don’t need them to be quiet to feel okay.

The E of this process is your coping statement that you’ll want to write down and integrate into your self-talk to move toward rational thinking. While this level of acceptance takes some time to develop, with practice we begin to realize that we can control our responses to situations we see as unpleasant.

APA Reference
Renzi, M. (2017, December 13). Rational Emotive Behavior Therapy (REBT) Reduces Anxiety, HealthyPlace. Retrieved on 2021, November 14 from



How Can Disputation Help Manage Social Anxiety?

Change Destructive Thinking:  Cognitive Restructuring & Mindfulness for Social Anxiety

Larry Cohen (NSAC cofounder and director of NSAC DC) explains how to use and combine these two very different strategies to overcome our anxiety-inducing hot thoughts.

Changing Perceptions in Social Anxiety (Cognitive Restructuring)

Learning to identify your hot thoughts (upsetting ideas, self-talk and mental images) that contribute to your social anxiety; learning to test these thoughts against real-life evidence; and learning to come up with a constructive attitude about the situation and yourself that is more realistic, helpful and compassionate.

Cognitive Restructuring alone is not always enough to overcome our distressing hot thoughts.

 Often, cognitive restructuring is a first step in preparing for experiments (see below), where we have the opportunity to test out our hot thoughts v. our constructive attitude about a situation and ourselves.

Sometimes we do cognitive restructuring during or after an upsetting situation so we can overcome our distress and learn from the experience.

Mindfulness for Social Anxiety

Learning to acknowledge and set aside your distracting and disturbing thoughts and feelings, and refocus your attention on the conversation and activity in the moment; learning to “get our of your head and into the moment” so that you can interact with others more comfortably and naturally.

Behavioral Experiments (Exposures) for Social Anxiety

Developing a series of learning experiences to help you work on your therapy goals and overcome your social anxiety in small, manageable steps.

 You choose your own experiments your fear and avoidance hierarchy, starting with situations that are only a little uncomfortable, and gradually working on harder things as you build self-confidence one small step at a time.

Generally you will do cognitive restructuring before the experiments, and practice mindfulness during the experiments (see above).  You will also identify safety behaviors (psychological crutches) that you want to limit using during your experiments so that you learn more and build more self-confidence.

Some of these experiments take place during therapy sessions: doing various moderately challenging role plays and other activities with the therapist, as well as going out in public with your therapist to do experiments with strangers.

 If you are in a social anxiety therapy group, you will do many of these in-session experiments together with other member of your group, and occasionally with former members of past groups.

 If you wish, you will have the option of making private video recordings of some of your in-session experiments so you can test out your hot thoughts about how you come across v. how you actually do appear.

You will also do many other experiments as self-chosen homework between sessions, either on your own, with therapy group co-members, or with personal friends.

Most importantly, you will also learn how to benefit from both your in-session and homework experiments, no matter how they turn out.

 You will learn how to identify ways you helped yourself, ways you unintentionally hurt yourself, and evidence you can gather from the experiments that refutes or supports your hot thoughts.

 You will also learn how to treat yourself compassionately about the experiments you do, a good parent or friend would do, so that you build self-confidence and make progress toward your goals more rapidly.

Assertiveness and Problem-Solving for Social Anxiety

Sometimes our social anxiety fears do come true.  Sometimes we do embarrass ourselves.  Sometimes others do judge or reject us, and may even say critical or mean things.

 Sometimes we create a bad impression.  These bad things don’t happen as often as we tend to think they do.  Nor do they usually have as negative or lasting an impact on our lives as we believe they will.

 Still, our fears do sometimes come true.

One important CBT strategy in overcoming social anxiety is learning to figure out what to do in the event our fears come true.  Sometimes that involves asserting yourself with a critical person in a calm and confident tone.

 We practice such assertions in session, using role plays and imagery, and we also practice it in various ways as homework.  Other times we use problem-solving strategies to develop good ways of coping with a situation turning out badly, which we also practice in session and in homework.

 The more confident we feel about being able to cope with a fear coming true with our heads held high, the less socially anxious we feel about the situation.

Changing Attitudes in Social Anxiety (Core Beliefs and Personal Rules)

Why do some people experience troubling hot thoughts and much anxiety about a situation in which many other people experience positive thoughts and feelings?  Some of this has to do with different attitudes (core beliefs and personalrules) that people have learned about themselves and the world as they grew up.  Our attitudes act glasses we wear: we don’t usually think of them, but nonetheless they profoundly affect the way we see the world and the situations we experience.   Change your glasses (attitudes), and the world looks very different to you.

CBT helps you identify the unhealthy core beliefs and rigid personal rules that contribute to your social anxiety.  You then learn various skills and strategies to test and weaken your unhealthy attitudes, and to develop and strengthen alternative, healthy attitudes.

The National Social Anxiety Center is a national association of regional clinics with certified cognitive therapists specializing in social anxiety and anxiety-related problems. We have compassionate therapists who can help you to reduce social anxiety.

Currently, we have regional clinics in San Francisco, District of Columbia, Los Angeles, Pittsburgh, New York City, Chicago, Newport Beach / Orange County, Houston / Sugar Land, St.

Louis, Phoenix, South Florida, Silicon Valley / San Jose, Dallas, Des Moines, San Diego, Baltimore, Louisville, Philadelphia, Montgomery County, Maryland / Northern Virginia, Long Beach, Staten Island, North Jersey, Brooklyn, and Santa Barbara.

Contact our national headquarters at (202) 656-8566 or visit our Regional Clinics contact page to find help in your local area.


REBT: A Smarter, More Effective Approach to Treatment

How Can Disputation Help Manage Social Anxiety?

What is Rational Emotive Behavior Therapy (REBT)? Created by Albert Ellis, REBT is a form of the very popular cognitive behavior therapy and has been dominating approaches to psychological treatment since the 1950s. You might be wondering what distinguishes REBT from other forms of psychotherapy techniques.

In essence, Albert Ellis created it as a philosophy of living – its foundation is the belief that it is not the events in our lives that cause our emotions, rather it is our beliefs that cause us to experience emotions such as anger, depression, and anxiety.

It is a mode to consider and change our irrational beliefs and has shown to have a favorable effect on reducing emotional pain.

REBT’s ABC Theory: The Diagnostic Step

Ellis’ theory that individuals are blaming outward events on their negative emotions instead of their interpretation of the events, the ABC Model was proposed as:

A – Activating Event: an event that happens in the environment

B – Beliefs: the belief you have about the event that happened

C – Consequence: the emotional response to your belief

This model was developed to educate others of how beliefs are the cause of emotional and behavioral responses, and not that events cause our emotional reactions.

Here’s an example that will help you understand better:

A – Your spouse falsely accuses you of cheating on him/her

B – You believe “What a jerk! S/he has no right to accuse me of that!

C – You feel angry/upset

If you had a different belief (B), the emotional response (C) would be different:

A – Your spouse falsely accuses you of cheating on him/her

B – You believe, “This cannot end our relationship – that would be too much to bear if we got a divorce.”

C – You feel anxious that your relationship might end

Here again, the ABC model is illustrating that it is not the event (A) that causes the emotional response, rather, it’s the belief (B) about the event that causes the emotional response (C). Because people interpret and respond differently to events, we don’t always have the same emotional response (C) to a given event.

The Three Musts of Irrational Thinking

The beliefs that end up in negative emotions are, according to Albert Ellis, a variation of three common irrational beliefs. Coined as the “Three Basic Musts,” these three common irrational beliefs are a demand – about ourselves, others, or the environment.

They are:

  1. I must do well and win others’ approval or else I am no good.
  2. Others must treat me fairly and kindly and in the same way I want them to treat me. If they do not treat me this way, they are not good people and deserve to be punished.
  3. I must always get what I want, when I want it. wise, I must never get what I don’t want. If I don’t get what I want, I’m miserable.

If we don’t realize “Must 1,” we ly feel anxious, depressed, shameful, or guilty. If we are not treated fairly, as per “Must 2,” we usually feel angry and may act violently. If we don’t get what we want, per “Must 3,” we may feel self-pity and procrastinate.

Disputing or Challenging the Irrational Beliefs and Changing our Behaviors

The second phase of REBT’s healing process is the dispute or challenge phase. That is, in order to act and feel differently, we must dispute or challenge the irrational beliefs we experience. Essentially, what we are questioning is our irrational beliefs:

Who says if I don’t win someone’s approval I’m no good?

Where is it written in the rule books that a boss always acts professionally and treats others fairly?

Why do I have to be absolutely miserable if I don’t get something I want? Why shouldn’t I just feel slightly annoyed instead of downright miserable?

Once individuals undergoing REBT can work through the dispute or challenge of their irrational thoughts, they can move toward how to engage in more effective thoughts, feelings, and behaviors.

Termed as an effective new philosophy on life, individuals in this phase start to recognize that there are no absolute “musts” – there is no evidence that suggests these “three musts” are the only way to think.

If you are undergoing this phase of REBT, you might start to reevaluate your responses:

“I don’t how my boss acted, but I can stand it.”

“Instead of feeling enraged that my spouse accused me of cheating, I will feel annoyed and determined to make my marriage work.”

“I think I’ll go to my exercise class after work – I think more clearly after engaging in physical exercise.”

Three Major Insights of REBT

According to Albert Ellis, the following are the three major insights of Rational Emotive Behavior Therapy:

  1. When individuals understand and accept that the main cause of emotional reactions are their beliefs about an event instead of the event itself. That is, we don’t just get upset from an event. We upset ourselves because of our irrational beliefs.
  2. When people acquire irrational beliefs, if they do not deal with them, they “hold” onto the beliefs and it’s what continues to upset them in the present. That is, these individuals still wholeheartedly believe in the “three musts.”
  3. Ellis made it clear that understanding these insights does not make us inherently “better.” That is, understanding these beliefs and having insights into how they effect our emotional responses is not enough to “cure” us. In reality, the best way to get better and stay better through REBT is to continually work on recognizing our irrational beliefs, disputing them, changing our irrational “musts,” and transforming negative emotions into more positive ones. Simply put, the only way to get better is through the hard work of changing our beliefs. It takes time and practice.


During Rational Emotive Behavior Therapy, individuals are taught about emotional health. If you are emotionally healthy, you experience an acceptance of reality, whether that reality is pleasant or unpleasant. Psychotherapists utilizing REBT teach their patients three forms of acceptance:

  1. Unconditional Self-Acceptance – I have flaws – I have my bad points and my good points, but that does not make me any less worthy than another person.
  2. Unconditional Other-Acceptance – Sometimes people won’t treat me fairly – there is no reason why they have to treat me fairly. Though some may not treat me fairly, they are no less worthy than any other person.
  3. Unconditional Life-Acceptance – Life is not always going to go the way I want. There’s no reason why it must go the way I want. I might experience some unpleasant things in life, but life itself is never awful and it is usually always bearable.

Using REBT to Treat Alcohol and Drug Dependencies

Statistics show that about 10% of the US population is suffering from a drug and/or alcohol dependency. Treatment programs for drug and alcohol abuse are highly beneficial; however, many people suffering from addictions do not seek help, and in some cases, don’t even realize they have a problem.

If you are suffering from a drug and/or alcohol dependency, the REBT way of thinking is that these unhealthy behaviors that you engage in are resultant from irrational beliefs and negative emotions associated with the irrational beliefs you are experiencing.

Thus, the crux of REBT in treating alcohol and drug dependencies is to facilitate sobriety and a return to health and happiness by reversing and/or lessening irrational thoughts and negative emotions that lead to addictive behaviors.

In 2010, up to 18% of drug and alcohol treatment centers in the United States were using REBT as their main treatment method in addressing addictive tendencies.

REBT has been found to work quite effectively with those suffering from addiction to both alcohol and drugs.

The core essence of treating individuals with addiction tendencies is to change the way they think about situations, have more positive emotional reactions, and in turn, alter the way they act  – that is, not seeking drugs or alcohol to cope with their emotions.

If you are suffering from an addiction, REBT can help you lessen the magnitude of your emotions. That is, instead of having a black and white emotion – “I must do my job perfectly. If I make a mistake, I’m a failure” into a less severe response. “I made a mistake on the job.

This is not the end of the world – we all make mistakes. It’s annoying that this happened, but I’ll work toward not making the same mistake in the future.” These subdued reactions lead to fewer self-defeating behaviors (e.g., turning to drugs and alcohol to cope).

Essentially, the two main ways REBT helps those with alcohol and drug dependencies is to teach individuals how to:

  1. React to situations in more realistic ways and not react to irrational thoughts.
  2. Realize there are some things we can’t control in life. But, we can control how we react to the situation.

REBT is often combined with other methods of treatment when addressing alcohol and drug dependencies. You may find yourself in a combination treatment program – the use of REBT in addition to other treatment methods such as group therapy (e.g.

, Alcoholics Anonymous; Narcotics Anonymous), drug rehabilitation facilities, drug treatments, and psychoeducational programs. Research has shown that the most influential treatment methods are combination treatments – most often behavioral therapies, REBT, combined with medical treatments (e.g., antidepressants).

However there are fundamental differences between REBT and AA/12 step programs that put them at odds with one another. REBT promotes an internal locus of control… you are in control of your own behaviors and emotions.

12 step programs focus on an external locus of control… you are diseased, your cannot control yourself and you must admit you’re powerless over alcohol, let go and let god.

REBT addiction expert Andy Orr best explains that “substance abuse and addictive behavior are learned or conditioned habit patterns“. Andy dismisses the premise of addiction as a disease: “On the contrary, I see substance abuse and addiction as dysfunctional or maladaptive behavior patterns that can be changed.”

The relapse rates for drug and alcohol abuse are up to 60% for those who do not complete treatment programs. So, it’s important to commit to the program once you seek REBT or other forms of treatment for drug and alcohol dependency.

REBT Interventions and Their Success Rates

If you undergo REBT, what can you expect? You will work through a variety of problems with your therapist and establish a number of goals of your therapy. The first step is understanding that a problem exists and having the willingness to change.

REBT works to help the client challenge, dispute, and question negative emotions, behaviors, and thoughts. Once this is uncovered, the therapist will focus on helping you transform your more irrational beliefs into rational and self-constructive thoughts. It’s not an easy process.

You can expect to continually work on these techniques – practice, practice, practice. As Ellis points out in his third insight – it’s not enough to recognize an irrational belief, we must rigorously dispute these again and again and refocus on more positive, constructive beliefs.

Change is not going to happen overnight.

So, is REBT an effective form of therapy? Absolutely. REBT has been studied time and again since the 1950s. Study after study has shown the positive effects of this method of therapy. The research has spoken that rational emotive behavior therapy is a validated method to change our negative responses and lead us to a happier life.

Read more about Albert Ellis.


Anxiety CBT Worksheets & Handouts

How Can Disputation Help Manage Social Anxiety?
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  • Brief Fear Of Negative Evaluation Scale | Leary | 1983
    • Scale download archived copy
  • Fear Questionnaire (FQ) (Phobia) | Marks, Matthews | 1979
    • Scale download archived copy
    • Marks, I. M., & Mathews, A. M. (1979). Brief standard self-rating for phobic patients.

       Behaviour Research and Therapy17(3), 263-267.

  • Generalized Anxiety Disorder 7-item (GAD-7) | Spitzer, Kroenke, Williams, Lowe | 2006
    • Scale  download
    • Spitzer RL, Kroenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety disorder. Arch Inern Med. 2006;166:1092-1097.

  • Hamilton Rating Scale For Anxiety (HAM-A) | Hamilton | 1959
    • Scale download archived copy
    • Hamilton, M. (1959).The assessment of anxiety states by rating. British Journal of Medical Psychology 32, 50-55.
  • Health Anxiety Inventory (HAI) | Salkovskis, Rimes, Warwick, Clark | 2002
    • Scale download
    • Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C., & Clark, D. M. (2002). The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32(05), 843-853.
  • Liebowitz Social Anxiety Scale (LSAS-SR) | Liebowitz | 1987
    • Scale download archived copy
  • Mobility Inventory For Agoraphobia (MIA) | Chambless, Caputo, Jasin, Gracely, Williams | 1985
    • Scale
    • Chambless, D. L., Caputo, G. C., Jasin, S. E., Gracely, E. J.

      , & Williams, C. (1985). The mobility inventory for agoraphobia. Behaviour research and therapy23(1), 35-44.

  • Panic Disorder Severity Scale (PDSS) | Shear, Brown, Barlow, Money, Sholomskas, Woods, Gorman, Papp | 1997
    • Scale download archived copy
    • Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E.

      , Woods, S. W., … & Papp, L. A. (1997). Multicenter collaborative panic disorder severity scale. American Journal of Psychiatry154(11), 1571-1575.

  • Penn State Worry Questionnaire | Meyer, Miller, Metzger, Borkovec | 1990
    • Scale
    • Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D.

      (1990). Development and validation of the penn state worry questionnaire. Behaviour Research and Therapy28(6), 487-495.

  • Spence Children’s Anxiety Scale | Spence | 1998
  • Severity Measure For Agoraphobia | Craske, Wittchen, Bogels, Stein, Andrews, Lebu | 2013
    • Scale – Adult download archived copy
  • Severity Measure For Generalized Anxiety Disorder | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Severity Measure For Panic Disorder | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
    • Scale – Adult download archived copy
  • Severity Measure For Social Anxiety Disorder | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Severity Measure For Specific Phobia | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Social Phobia Inventory (SPIN) | Connor, Davidson, Churchill, Sherwood, Weisler, Foa | 2000
    • Scale download archived copy
  • Social Phobia Scale | Mattick, Clarke | 1995
    • Scale download archived copy
  • NICE guidelines for GAD and panic | 2011  download
  • NICE guidelines for social anxiety disorder | 2013  download
  • Comprehensive cognitive behavior therapy for social phobia: a treatment manual | Ledley, Foa, Huppert, Clark | 2006  download
  • Treatment manual for panic disorder (IAPT treatment manual for high intensity CBT therapists) | Clark, Salkovskis | 2009 download archived copy
  • A brief cognitive-behavioural treatment for social anxiety disorder | Morris, Mensink, Stewart  download  archived copy
  • Assertive defense of the self | Padesky | 1985 download archived copy
  • Interoceptive exposure definition | White, Basden, Barlow download archived copy
  • Task concentration training definition | Bögels download archived copy
  • Task concentration training and fear of blushing | Bögels, Mulkens, De Jong | 1997 download archived copy
  • Health anxiety – a self-help guide download archived copy
  • Panic self-help booklet by Dr Charles Young download archived copy
  • Panic self-help booklet from Glasgow STEPS including information about panic and self-help interventions download archived copy
  • Phobia self-help booklet from Glasgow STEPS including information about phobia and self-help interventions download archived copy
  • ‘Shyness and social anxiety – a self help guide’ is an excellent resource download archived copy
  • Understanding health anxiety download
  • How health anxiety develops download
  • What keeps health anxiety going? download
  • Reducing your focus on health anxiety symptoms and worries download
  • Re-evaluating unhelpful health-related thinking download
  • Reducing checking and reassurance seeking download
  • Challenging avoidance and safety behaviors download
  • Adjusting health rules and assumptions download
  • Healthy living and self-management planning download
  • New developments in exposure therapy for anxiety and related disorders: the inhibitory learning approach | Blakey, Abramowitz | 2018  download archived copy
  • Desirable difficulties: optimizing exposure therapy for anxiety through inhibitory learning | Abramowitz, Jacoby, Blakey | 2018 download archived copy
  • GAD – a cognitive model and treatment download  archived copy
  • Bringing Specificity to Generalized Anxiety Disorder: Conceptualization and Treatment of GAD using Intolerance of Uncertainty as the Theme of Threat | Robichaud | 2013 download archived copy
  • Clark, D. M. (1999). Anxiety disorders: why they persist and how to treat them. Behaviour Research and Therapy, 37, S5-S27 download archived copy
  • Behar, E., DiMarco, I. D., Hekler, E. B., Mohlman, J., Staples, A. M. (2009). Current theoretical models of generalized anxiety disorder (GAD): Conceptual review and treatment implications. Journal of Anxiety Disorders, 23, 1011-1023 download archived copy
  • Bottesi, G., Ghisi, M., Carraro, E., Barclay, N., Payne, R., & Freeston, M. H. (2016). Revising the Intolerance of Uncertainty Model of Generalized Anxiety Disorder: Evidence from UK and Italian Undergraduate Samples. Frontiers in psychology, 7, 1723 download  archived copy
  • Milne, S., Lomax, C., & Freeston, M. H. (2019). A review of the relationship between intolerance of uncertainty and threat appraisal in anxiety. the Cognitive Behaviour Therapist, 12. download

A number of treatment packages have demonstrated efficacy in the treatment of GAD:

Laval model

  • Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour research and therapy, 36(2), 215-226.

Avoidance model of worry and GAD

  • Borkovec, T. D., Alcaine, O., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. Generalized anxiety disorder: Advances in research and practice, 2004.
  • Hjemdal, O., Hagen, R., Nordahl, H. M., & Wells, A. (2013). Metacognitive therapy for generalized anxiety disorder: Nature, evidence and an individual case illustration. Cognitive and Behavioral Practice, 20(3), 301-313 download  archived copy

Metacognitive model

  • Hjemdal, O., Hagen, R., Nordahl, H. M., & Wells, A. (2013). Metacognitive therapy for generalized anxiety disorder: Nature, evidence and an individual case illustration. Cognitive and Behavioral Practice, 20(3), 301-313.
  • Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and cognitive psychotherapy, 23(3), 301-320 download  archived copy

Emotional dysregulation model

  • Fresco, D. M., Mennin, D. S., Heimberg, R. G., & Ritter, M. (2013). Emotion regulation therapy for generalized anxiety disorder. Cognitive and Behavioral Practice, 20(3), 282-300
  • Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2002). Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice, 9(1), 85-90 download  archived copy

Acceptance-based model of GAD

  • Roemer, L., & Orsillo, S. M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance‐based approaches with existing cognitive‐behavioral models. Clinical Psychology: Science and Practice, 9(1), 54-68 download  archived copy
  • Roemer, L., Salters, K., Raffa, S. D., & Orsillo, S. M. (2005). Fear and avoidance of internal experiences in GAD: Preliminary tests of a conceptual model. Cognitive Therapy and Research, 29(1), 71-88.

Health Anxiety

  • Asmundson, G. J. G., Abramowitz, J. S., Richter, A. A., Whedon, M. (2010). Health anxiety: current perspectives and future directions. Current Psychiatry Reports, 12, 306-312 download
  • Furer, P., Walker, J. R. (2008). Death anxiety: A cognitive behavioural approach. Journal of Cognitive Psychotherapy, 22(2), 167-182 download
  • Salkovskis, P. M., Warwick, H. M. C.

    , Deale, A. C. (2003). Cognitive-Behavioral Treatment for Severe and Persistent Health Anxiety (Hypochondriasis). Brief Treatment and Crisis Intervention, 3, 353-367 archived copy

  • Walker, J. R., Furer, P. (2008). Interoceptive exposure in the treatment of health anxiety and hypochondirasis.

    Journal of Cognitive Psychotherapy, 22(4), 366-378 download

Panic disorder

  • Clark D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24:461–470. download archived copy
  • Clark, D. A. (1999). Anxiety disorders: Why they persist and how to treat them.

    Behaviour Research and Therapy, 37, S5-S27 download archived copy

  • Huppert, J. D., & Baker-Morissette, S. L. (2003). Beyond the manual: The insider’s guide to panic control treatment. Cognitive and Behavioral Practice10(1), 2-13.
  • Schmidt, N. B.

    , Woolaway-Bickel, K., Trakowski, J. et al. (2000). Dismantling cognitive-behavioural treatment for panic disorder: Questioning the utility of breathing retraining. Journal of Consulting and Clinical Psychology, 68(3), 417-424 download archived copy

  • Wells, A. (1997).

    Cognitive Therapy of Anxiety Disorders. Chichester: Wiley.

Social Anxiety Disorder

  • Clark, D. M. (2001). A cognitive perspective on social phobia download archived copy
  • Moscovitch, D. A. (2009). What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioural Practice, 16.

    123-134 download archived copy

  • Wild, Hackmann, Clark (2008). Rescripting early memories linked to negative images in social phobia: a pilot study. Behaviour Therapy, 39(1), 47-56. download
  • Veale, D. (2003). Treatment of social phobia.

    Advances in Psychiatric Treatment, 9, 258-264 download archived copy

  • Warnock-Parkes, E., Wild, J., Stott, R., Grey, N., Ehlers, A., & Clark, D. M. (2017). Seeing is believing: Using video feedback in cognitive therapy for social anxiety disorder.

    Cognitive and behavioral practice, 24(2), 245-255. view archived copy


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