Cognitive restructuring treatment: A controlled trial with anxious patients

Cognitive restructuring, modified systematic desensitization and a combined treatment (cognitive behaviour modification) were compared with a no-treatment control group, using a simple randomized design. Twenty seven general anxiety out-patients selected from the hospital waiting list were used as subjects. Assessments were made at the beginning and end of treatment, and at follow-up 1 month later. The assessments included two subjective anxiety measures, the Zung self-rating anxiety scale and fear thermometer scores, a behavioural anxiety measure, a measure of cognitive anxiety as estimated by a diary recording of thinking time, fear survey schedule scores and I/E scores.Cognitive behaviour modification was found to be a superior form of treatment, relative to the no-treatment control and the other active treatment groups as assessed by FSS intensity score. The cognitive behaviour modification group showed greater improvement than the cognitive restructuring group on the diary anxiety scores. The results also demonstrated a relationship between outcome and initial severity of condition. The higher the subjects' initial scores on neurotic symptoms and subjective anxiety level, the greater the degree of positive change after treatment. Moreover, subjects with high levels of internal control prior to treatment responded most to therapy.