**3.3 Cognitive behavioural therapy (CBT)**

Since the 1960s, cognitive behavioural theory has gained popularity. CBT uses a combination of behavioural and cognitive interventions aimed at changing negative thinking patterns and behaviours and is one of the most researched psychological interventions [43]. CBT is frequently used in the clinical environment and its practice is evidence-based. It focuses on the way individuals think and act in specific circumstances and how emotional and behavioural problems may be overcome. It adopts a formulation of protocols and procedures that are used to treat psychological conditions, and enables development of flexible realistic beliefs [22]. Individuals are helped in the pursuit of goals, and emotional problems are aided and overcome by directing cognitions towards memories, images, thoughts and attention [42].

Specific patterns of thinking are associated with a range of psychological problems and through its development, CBT has adopted treatments for anxiety conditions and emotional disorders such as depression, generalised anxiety disorder, panic disorder, post-traumatic stress and specific phobias [44]. There are a number of distinctive diktats and protocols that contribute to an effective model of CBT. Various longitudinal formulations have been devised to aid the management and treatment of problems. However, for the purpose of this review, the formulation devised by Persons [45] is used, as this diagram is most usually associated with CBT and bridges the gap between behavioural and cognitive formulations [38]. An adaptation of the diagram illustrates the relationship to the root cause and effect of anxiety.
