Ethical Anxiety Care in Dubai: Exactly How CBT Works
Updated: 1 day ago
For adults with anxiety disorders, cognitive behavioural therapy (CBT) is a well-studied psychological approach. A meta-analysis of 41 randomised placebo-controlled trials found moderate effects of CBT on the symptoms of the disorder being treated (Carpenter et al., 2018). This post explains how CBT works, what the research says, and where Sarah El Nabulsi's courses and sessions fit.
Why CBT
The trials in that meta-analysis covered generalised anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder and acute stress disorder. Effects were larger for some of these than for others (Carpenter et al., 2018), which is one reason CBT is fitted to the person and the problem rather than applied the same way to everyone.
Exposure is a core part of CBT for anxiety: facing feared situations or body sensations step by step, rather than avoiding them. In the same meta-analysis, treatments built mainly on exposure showed larger effects than those built mainly on cognitive techniques, although the difference was not statistically significant (Carpenter et al., 2018). One current approach plans exposure around inhibitory learning: the aim is to learn that the feared outcome does not happen, not simply to wait for the fear to fade (Craske et al., 2014).
Delivery format: a meta-analysis of eight trials that compared internet-delivered CBT directly with face-to-face CBT for anxiety disorders found equivalent overall effects, and its authors note that more research is needed (Esfandiari et al., 2021). Those trials tested structured internet programmes, not video sessions with a therapist.
Durability: a meta-analysis of 17 studies found that relapse after CBT for anxiety-related disorders occurred in a minority of people who had reached remission, about 14% overall, and its authors point to relapse-prevention skills as the place for further work (Levy et al., 2021).
Where the courses fit
Sarah El Nabulsi's two online courses teach the foundations of CBT at your own pace. They are education, not therapy, and not a substitute for it.
Level 1, Anxiety 101: how anxiety works in the body, how to rate your own symptoms, and the basics of CBT, in the order she teaches them.
Level 2, Master Yourself: builds on Anxiety 101, with the patterns underneath anxiety, such as avoidance, and daily tools for the mind and the body.
Sessions with Sarah El Nabulsi
Sarah El Nabulsi is a DHA-licensed clinical psychologist in Dubai with fifteen years in private practice, working with adults and couples in Arabic, English and French. She works with CBT alongside integrative approaches. Sessions are in person in Dubai, and online for clients in the UAE.
How long does CBT take?
There is no fixed number of sessions that suits everyone. It depends on what you are working on and how long it has been there, and it is a fair question to ask when you book.
References
Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A. J., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depression and Anxiety, 35(6), 502–514. https://doi.org/10.1002/da.22728
Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23. https://doi.org/10.1016/j.brat.2014.04.006
Esfandiari, N., Mazaheri, M. A., Akbari-Zardkhaneh, S., Sadeghi-Firoozabadi, V., & Cheraghi, M. (2021). Internet-delivered versus face-to-face cognitive behavior therapy for anxiety disorders: Systematic review and meta-analysis. International Journal of Preventive Medicine, 12, 153. https://doi.org/10.4103/ijpvm.ijpvm_208_21
Levy, H. C., O'Bryan, E. M., & Tolin, D. F. (2021). A meta-analysis of relapse rates in cognitive-behavioral therapy for anxiety disorders. Journal of Anxiety Disorders, 81, 102407. https://doi.org/10.1016/j.janxdis.2021.102407
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