Health anxiety: cognitive behavioral therapy for anxiety

Introduction: Health anxiety, also known as ‘hypochondriasis’, is a common, distressing and costly condition that responds to cognitive behavior therapy(CBT) but evidence pertaining to response and remission rates, treatment in routine care, therapist-guided Internet-delivered CBT (ICBT) and health economics has not been systematically reviewed.

Cognitive behavioral therapy (CBT) can be an effective treatment for health anxiety. It focuses on identifying and challenging negative thought patterns and beliefs related to health concerns. CBT for health anxiety typically involves techniques such as:

Cognitive restructuring: This involves identifying and challenging irrational or unhelpful thoughts about health, and replacing them with more realistic and balanced thoughts.

1. Behavioral techniques: These may include facing feared situations gradually to reduce avoidance and safety behaviors, as well as practicing relaxation techniques to manage anxiety.

1. Education and psychoeducation: Learning more about health anxiety and the factors that contribute to its maintenance can help individuals gain a better understanding of their symptoms and reduce anxiety.

1. If you are struggling with health anxiety, it would be beneficial to seek out a qualified mental health professional who is experienced in CBT. They can work with you to develop a personalized treatment plan to address your specific concerns.

Cognitive Behavioural Therapy (CBT) 

will teach you to understand your problem better, and to interpret symptoms and changes in your body in less frightening ways. Special techniques are used to help you identify things which trigger worries about health and the upsetting thoughts you have. Such thoughts lead to changes in behaviour (e.g. checking your body repeatedly and seeking lots of reassurance).

CBT will help you modify these changes in thoughts and behaviour, which is likely to lead to overall reduction in health anxiety. When appropriate, you may also learn techniques that will help to reduce anxiety and the symptoms that are bothering you. You will be offered up to 10 remotely delivered sessions using an internet system called Webex. Each session will last for up to an hour. Here’s what you will need to do.

Elements of Cognitive Behavioural Therapy

1. Diary and record keeping: 

To get the most from each CBTsession and keep track of your progress, you may be asked to complete a diary and records of your feelings. These give us important information about your problems. It is important to fill these in as carefully as possible and have them available at your sessions. 

2. Agenda setting: 

To make the best use of each session, you and your therapist will plan

an agenda for that session. This may involve looking at diaries and records, discussing any symptoms or worries you have had, what progress you have made with treatment and what problems are left. Decide which issues are the most pressing and how long you want to spend on each one. You will usually accomplish more by tackling things one at a time. 

3. Session summary

Towards the end of the session you and your therapist will review what has been accomplished during the session. This is important to make sure you have followed all the things to be learned about your problems in that session. You will also be given a recorded copy of the session to listen to each week, to enhance learning and bring back any

questions to your therapist.

4. Working at the treatment

In CBT you and your therapist will be working hard to find out what keeps your health anxiety going, so you can overcome it permanently. It has been shown over and over again that reassurance is a very poor way of tackling health anxiety. This is not surprising, as reassurance is generally intended to show you what is NOT wrong with you. This may work in the short term, but not in the longer term. The best way of dealing with health anxiety long-term is to learn how your symptoms can be caused and to be reminded of the ways in which you can resolve them. This allows you to understand what your problem IS rather than

what it IS NOT, and lets you develop the skills to deal with health anxiety should it return.

5. Homework

Therapy sessions are for one hour each week and there will be lots of things you will want to follow up between sessions. You will be asked to perform homework assignments between

the sessions and this will speed up your progress in learning to completely control your health anxiety. This is essential in building your confidence and making the most of your therapy.

6. Becoming your own therapist

One of the most important goals of cognitive behavioural therapy is for you to learn how to be your own therapist. You will learn to identify thoughts, beliefs about symptoms, and your

behaviour in a broader way, so that if you have any recurrence in the future you will have the skills to deal with them