Cognitive Behavioral Therapy
What it is
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Why it is on this page
People: People with GAD at step 3: marked functional impairment or no improvement after step 2 interventions
Official guideline documents · checked Oct 16, 2026
Relationship: NICE CG113 recommends CBT as one high-intensity psychological option for GAD at Step 3
Statement scope
- Choice
high-intensity psychological intervention
- Guideline
CG113
- Issuer
National Institute for Health and Care Excellence
- Jurisdiction
England (NICE guidance)
- Population
People with GAD at step 3: marked functional impairment or no improvement after step 2 interventions
- Recommendation
1.2.18
Source collection coverage: global
Pointer: /document/recommendation
Open sourceSource: Official guideline documents. Checked Oct 16, 2026. Scope: global. Link: https://www.nice.org.uk/guidance/cg113/chapter/Recommendations
Research for Generalized anxiety disorder
Research suggests benefit in this exact scope
Published Oct 3, 2026 · revision 2
What research says
In a network meta-analysis of adult GAD psychotherapy trials, CBT was associated with lower anxiety symptom severity than treatment as usual at treatment end (SMD −0.74; 95% CI −1.09 to −0.38), with moderate certainty. This aggregate result does not establish personal suitability or current access at any provider.
PubMed Central open-access full text · checked Oct 3, 2026
Relationship: supports bounded adult GAD CBT conclusion
Statement scope
- Comparator
Treatment as usual
- Intervention
Cognitive behavioral therapy
- Method
Corrected systematic review and network meta-analysis of randomized clinical trials
- Outcome
Generalized anxiety symptom severity
- Population
Adults with a primary diagnosis of generalized anxiety disorder
- Time point
End of treatment
Source collection coverage: global
Pointer: /article/acuteResult
Supporting passage: CBT (SMD, −0.74 [95% CI, −1.09 to −0.38]; certainty, moderate)
Open sourceSource: PubMed Central open-access full text. Checked Oct 3, 2026. Scope: global. Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC10585589/
Guideline role
England’s NICE guideline CG113, recommendation 1.2.18, discusses high-intensity psychological treatment in its adult GAD Step 3 pathway: marked impairment in functioning or insufficient improvement with Step 2 care. That pathway offers a choice between CBT and applied relaxation.
Official guideline documents · checked Oct 16, 2026
Relationship: supports the attributed Step 3 guideline role
Statement scope
- Choice
high-intensity psychological intervention
- Guideline
CG113
- Issuer
National Institute for Health and Care Excellence
- Jurisdiction
England (NICE guidance)
- Population
People with GAD at step 3: marked functional impairment or no improvement after step 2 interventions
- Recommendation
1.2.18
Source collection coverage: global
Pointer: /document/recommendation
Open sourceSource: Official guideline documents. Checked Oct 16, 2026. Scope: global. Link: https://www.nice.org.uk/guidance/cg113/chapter/Recommendations
Delivery and time commitment
Under England’s NICE CG113 protocol (recommendation 1.2.19), a typical CBT course for adults in the GAD Step 3 pathway involves 12–15 appointments, held weekly for one hour apiece. A course may end earlier when the person recovers or be extended for clinical reasons. Delivery requires an appropriately trained, competent practitioner following the CBT manuals from GAD trials. These are guideline expectations for that pathway; a local provider’s schedule and an individual’s needs may differ.
Official guideline documents · checked Oct 3, 2026
Relationship: supports the attributed usual delivery schedule and its exceptions
Statement scope
- Delivery
be based on the treatment manuals used in the clinical trials of CBT for GAD; be delivered by trained and competent practitioners; usually consist of 12 to 15 weekly sessions (fewer if the person recovers sooner; more if clinically required), each lasting 1 hour
- Guideline
CG113
- Indication
Step 3: GAD with marked functional impairment or that has not improved after step 2 interventions
- Population
Adults covered by NICE CG113, within the retained GAD Step 3 scope
- Recommendation
1.2.19
- Recommendation year
2011
Source collection coverage: global
Pointer: /document/recommendation
Open sourceSource: Official guideline documents. Checked Oct 3, 2026. Scope: global. Link: https://www.nice.org.uk/guidance/cg113/chapter/Recommendations
Compared with the others: Not directly compared. We show each option’s own research.