Does CBT Change Brains?

Multiple studies have shown that cognitive behavioral methods change the brain of people with anxiety problems… in much the same way as medications change the brain.

Does Cognitive Behavioral Therapy Change the Brain? A Systematic Review of Neuroimaging in Anxiety Disorders

EPatricia Ribeiro Porto; Leticia Oliveira; Jair Mari; Eliane Volchan; Ivan Figueira; Paula Ventura
The Journal of Neuropsychiatry and Clinical Neurosciences 2009;21:114-125.

This systematic review examined how Cognitive Behavioral Therapy (CBT) modified the neural circuits involved in regulating negative emotions and in fear extinction. In this study, the researchers reviewed available studies that had been conducted to investigate the neural mechanisms by which Cognitive Behavioral Therapy works in the treatment of anxiety disorders. Ten neuroimaging studies that employed functional magnetic resonance (fMRI) and positron emission tomography (PET) methods were reviewed. These studies investigated the neurobiological changes experienced in individuals treated for obsessivecompulsive disorder (OCD), posttraumatic stress disorder (PTSD), specific phobia, panic disorder, and social phobia.

These reviewers found that the ten studies isolated a number of subcortical and cortical regions associated with successful treatment of anxiety disorders with CBT. Although the regions of the brain identified in the various studies were not entirely uniform, due to variations in methodology and in the problems being studied, key limbic and cortical structures were identified and the review concluded that CBT produced noteworthy changes in predictable pathways.

The researchers concluded that the studies “demonstrate that CBT is able to modify the dysfunctional neural activity related to anxiety disorders in the patients who responded to treatment.” Their review of studies that investigated both CBT and medication interventions “suggests that psychotherapy with CBT and drug therapy may act in similar brain circuits.”

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