EFFECTIVENESS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) IN REDUCING ANXIETY SYMPTOMS ACROSS DIFFERENT ANXIETY DISORDERS COMPARED TO CONTROL CONDITIONS AND ALTERNATIVE TREATMENTS: A SYSTEMATIC LITERATURE REVIEW

Sadagat Majidli; Sadagat Mammadova; Gulay Mammadova; Gulshan Aliyeva

doi:10.31435/ijitss.1(49).2026.4602

Sadagat Majidli Senior year student, Faculty of Humanities and Social Sciences, Department of Psychology, Khazar University, Baku, Azerbaijan
Sadagat Mammadova Senior year student, Faculty of Humanities and Social Sciences, Department of Psychology, Khazar University, Baku, Azerbaijan
Gulay Mammadova Senior year student, Faculty of Humanities and Social Sciences, Department of Psychology, Khazar University, Baku, Azerbaijan
Gulshan Aliyeva PhD in Psychology, Academic Advisor, Department of Psychology, Khazar University, Baku, Azerbaijan https://orcid.org/0000-0001-9771-1156

DOI: https://doi.org/10.31435/ijitss.1(49).2026.4602

Keywords: Mental health, Cognitive Behavioral Therapy, Anxiety Disorders, Systematic Review, Treatment Outcome

Abstract

Background: Anxiety disorders are among the most prevalent mental health conditions worldwide. Cognitive Behavioral Therapy (CBT) is widely regarded as a first-line treatment, but its evidence base is constantly evolving with new research on long-term outcomes, comparative efficacy, and novel delivery methods. The first aim of this mixed methods review is to explore the efficacy and long-term effectiveness of CBT for anxiety disorders. The secondary aims evaluate the comparative effectiveness of its various delivery modalities (e.g., face-to-face, digital, virtual reality) and its efficacy relative to other active treatments, such as pharmacotherapy and emerging psychotherapies.

Methods: A systematic review was conducted based on a synthesis of 12 peer-reviewed research summaries, including meta-analyses, randomized controlled trials, and longitudinal studies. The population included children, adolescents, and adults with diagnosed anxiety disorders. Interventions included standard CBT and its variants (e.g., ICBT, VRCBT, CBGT). Outcomes included reduction in anxiety symptoms, long-term maintenance of gains, quality of life improvements, and comparative efficacy between modalities.

Conclusions: The results from this review will provide evidence that CBT is a highly effective treatment for a range of anxiety disorders, showing medium to large effect sizes. CBT remains the gold-standard, evidence-based psychological intervention for anxiety disorders. Its benefits are durable over time and can be effectively delivered through both traditional and emerging digital formats, which can help bridge the accessibility gap. These findings clarify that, future research should focus on long-term follow-ups, optimizing digital engagement, and adapting protocols for diverse cultural and clinical populations.

References

Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and anxiety, 35(6), 502-514.

Erickson, D. H., Janeck, A. S., & Tallman, K. (2007). A cognitive-behavioral group for patients with various anxiety disorders. Psychiatric Services, 58(9), 1205-1211.

Kodal, A., Fjermestad, K., Bjelland, I., Gjestad, R., Öst, L. G., Bjaastad, J. F., ... & Wergeland, G. J. (2018). Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. Journal of anxiety disorders, 53, 58-67.

Hofmann, S. G., Wu, J. Q., & Boettcher, H. (2014). Effect of cognitive-behavioral therapy for anxiety disorders on quality of life: a meta-analysis. Journal of consulting and clinical psychology, 82(3), 375.

Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in clinical neuroscience, 17(3), 337-346.

Kendall, P. C., Ney, J. S., Maxwell, C. A., Lehrbach, K. R., Jakubovic, R. J., McKnight, D. S., & Friedman, A. L. (2023). Adapting CBT for youth anxiety: Flexibility, within fidelity, in different settings. Frontiers in psychiatry, 14, 1067047.

Lv, Z., Li, J., Zhang, B., Zhang, N., & Wang, C. (2021). The effect of computerized cognitive behavioral therapy on people's anxiety and depression during the 6 months of Wuhan's lockdown of COVID-19 epidemic: a pilot study. Frontiers in Psychology, 12, 687165.

Mursaleen, M., Shaikh, S. I., & Imtiaz, S. (2025). The Role of Cognitive Behavioral Therapy (CBT) in Treating Anxiety Disorders: A Meta-Analytical Review. Journal of Applied Linguistics and TESOL (JALT), 8(1), 1074-1083.

Otte, C. (2011). Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues in clinical neuroscience, 13(4), 413-421.

Stewart, R. E., & Chambless, D. L. (2009). Cognitive–behavioral therapy for adult anxiety disorders in clinical practice: A meta-analysis of effectiveness studies. Journal of consulting and clinical psychology, 77(4), 595.

Wu, J., Sun, Y., Zhang, G., Zhou, Z., & Ren, Z. (2021). Virtual reality-assisted cognitive behavioral therapy for anxiety disorders: a systematic review and meta-analysis. Frontiers in psychiatry, 12, 575094.

Zhang, W., Du, Y., Yang, X., Wang, E., Fang, J., Liu, Z., ... & Hu, Y. (2022). Comparative efficacy of face-to-face and internet-based cognitive behavior therapy for generalized anxiety disorder: a meta-analysis of randomized controlled trial. Frontiers in Psychiatry, 13, 832167.