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

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.