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Is CBT effective for relationship anxiety?

CBT is now considered by many to be the gold standard for anxiety treatment—it’s focused, swift, and it works.

Proven Success → CBT consistently delivers results across all types of anxiety.
Long-Term Impact → Studies show CBT creates lasting change in how we think and respond.
NHS-Endorsed → CBT is recommended in the NHS’s stepped mental health care approach for anxiety.

Yet despite its strong reputation for phobias, OCD, and depression, CBT played a smaller role in relationship therapy, where more traditional talking therapy approaches still dominate.

But this is not my personal experience.

Over 15 years ago, I was offered CBT through the NHS—for debilitating relationship anxiety. It had such a powerful effect, I later trained in CBT myself. I wanted to understand why it worked so quickly and why it was not being used more widely for relationship anxiety.

Comparing CBT with traditional relationship therapy

Psychoanalytic/Psychodynamic

Rooted in Freudian theory, psychodynamic therapy remains highly respected in relationship work. It helps clients explore how childhood experiences may be shaping their relationships.

Its strengths:

• Offers deep insight into our childhood relationship patterns.

• Can help clients connect past and present emotional experiences.

But it has limits:

• Insight doesn't equal change. Recognising the problem doesn’t often stop the emotional reaction or behaviour.

• Lengthy process. This style of therapy can take many months—or even years.

• Trauma risks. Revisiting childhood pain can sometimes trigger or worsen symptoms.

• Dependency risk. Long-term therapy may create emotional reliance on the therapist.

CBT approach to relationship therapy

CBT takes a different view. Rather than searching endlessly for the cause, CBT focuses on changing the present.

• It teaches clients how to identify negative thought patterns, behaviours, and emotional triggers - so they can become their own therapist.

• It teaches practical, solution-based tools.

• Clients often experience change within 8–10 sessions.

• CBT encourages clients to build resilence and independence from the first session.

In my clinic, I pair CBT with hypnotherapy to increase creativity and lateral thinking, allowing clients to develop innovative, strategies for dealing with emotional blocks.

What does the research say?

1. CBT is Effective for Relationship Conflict & Improves Relationship Satisfaction

Studies show CBT helps reframe negative thoughts and reduce reactivity in high-conflict relationships.

e.g., Quarterly Journal of Conflict Resolution (2022); CBT & Marital Quality Study (2016)

2. CBT Reduces Commitment Anxiety & Relationship OCD (ROCD)

CBT helps with fear of making the wrong choice, constant doubt, and overthinking in relationships.

e.g., Pabroski (2015); “Relationship OCD: A Clinician’s Guide to Effective Treatment”

3. CBT Supports Divorce & Breakup Recovery

Research shows CBT helps individuals move on from heartbreak, rebuild confidence, and overcome breakup-induced depression.

e.g., Journal of Social Science Review (2023); Soltani & Fatehizade (2020)

4. CBT Reducing Jealousy Driven Relationship Conflict & Insecurity

CBT combined with mindfulness has been shown to reduce obsessive jealousy and emotional reactivity.

e.g., International Journal of Cognitive Therapy (2017); Romantic Jealousy Study (2023)

5. CBT Heals Narcissistic Trauma Recovery and Emotional Abuse

CBT helps survivors rebuild self-trust, reduce shame, and regulate distress after toxic relationships.

e.g., Clinical Psychology Research & Practice; Kia et al. (2024)