How well does talking therapy really work for anxiety? A team of researchers went looking for the most demanding evidence they could find: randomised trials where CBT was tested against a placebo, published since 2017.
They found ten such trials, covering 1,250 people. Seven of the ten focused on PTSD.
The results were more modest than you might expect. CBT did outperform placebo, but the advantage was small, and smaller than earlier reviews had suggested. Its effect on accompanying depression wasn't statistically clear at all.
Some context matters here. Comparing therapy against a placebo is a deliberately hard test, because a psychological placebo usually still means real time with a supportive professional. So this measures the extra benefit of CBT's specific techniques, not whether therapy beats doing nothing. The authors also note that most of these trials studied PTSD, and very few placebo-controlled trials of other anxiety disorders have appeared recently.
What does that mean for you? CBT remains among the best-supported treatments for anxiety, and honest appraisals like this one are how the field keeps its claims proportionate and shows where more evidence is still needed.
If anxiety is weighing on you, a psychologist can talk through the options and what the evidence genuinely supports.