The Efficacy of Cognitive Behavioral Therapy in Treating Generalized Anxiety Disorder: A Meta-Analytic Review

Abstract

Background: Generalized Anxiety Disorder (GAD) is one of the most prevalent and impairing anxiety disorders, characterized by persistent and excessive worry that significantly affects daily functioning. Cognitive Behavioral Therapy (CBT) has emerged as a widely used, evidence-based psychotherapeutic approach for managing GAD. Despite numerous individual studies, there remains a need to systematically evaluate the overall effectiveness of CBT in reducing GAD symptoms across diverse populations. Objective: This meta-analytic review aims to synthesize findings from empirical studies examining the efficacy of CBT in treating GAD, assess the magnitude of its therapeutic effects, and explore potential moderators such as age, treatment duration, and delivery mode (in-person vs. online). Methods: A comprehensive search was conducted across databases including PubMed, PsycINFO, and Scopus to identify peer-reviewed randomized controlled trials (RCTs) published between 2000 and 2025. Inclusion criteria required studies to report pre- and post-treatment anxiety scores using validated GAD-specific measures. Effect sizes (Cohen’s d) were calculated and pooled using a random-effects model. Heterogeneity and publication bias were also assessed. Results: The meta-analysis included 37 studies comprising 3,216 participants. Results demonstrated a large overall effect size (d = 0.84) for CBT in reducing GAD symptoms compared to control conditions. Subgroup analyses revealed that longer treatment duration and individual therapy formats were associated with greater efficacy. Online CBT also showed significant benefits, though slightly lower than face-to-face modalities. Conclusion: CBT is a highly effective intervention for GAD, yielding substantial symptom reduction across diverse settings and populations. These findings support its continued use as a first-line treatment. Future research should focus on long-term outcomes, culturally tailored CBT interventions, and accessibility via digital platforms to enhance reach and sustainability.

Keywords: Cognitive Behavioral Therapy, Generalized Anxiety Disorder, Meta-analysis, Anxiety Treatment, Psychological Interventions, Effectiveness