Panel Discussion 10 - Cross Disciplinary Perspectives on When and How to Be ‘done’ with CBT and What Happens After

Long-term ( > 2 years) treatment follow-up studies show that a minority (~38% or less) of individuals who undergo cognitive behavioral therapy (CBT) for anxiety or depression maintain sustained recovery without additional interventions (Conradi et al., 2017; Durham et al., 2012). Even among those who respond to CBT, many will experience a relapse or recurrence (average of ~30% for depression and ~15% for anxiety within 1 year after treatment, Van Dis et al., 2020; Vittengl et al., 2007). Longer-term outcomes for anxiety and depressive disorders are likely even less favorable, as persistent subclinical symptoms and (re)emergence of internalizing disorders are common (Judd et al., 1998, Scholten et al., 2012, Solis et al., 2021). Although CBT shows lasting treatment effects (Cuijpers et al., 2013; Hollon et al., 2006), recurrence and subclinical symptoms spanning years remain prevalent in treated anxiety and depression, thus, enhancing longevity of CBT's effects is an important area for continued research and discussion. Our session aims to delve into clinical strategies for improving long-term treatment outcomes for anxiety and depression, integrating findings from diverse fields (e.g., neuroscience, basic science in fear learning, computational approaches, and translational research broadly). It brings together field leaders in anxiety and depression treatment with expertise spanning the diverse disciplines outlined. Discussion topics will include mechanistic insights into determining treatment endpoints and optimizing treatment protocols to reduce recurrence risk and increase likelihood of more comprehensive and enduring remission through cognitive behavioral interventions. Panelists will also discuss adjunctive interventions (e.g., digital, mindfulness-based, and pharmacological) that may enhance CBT’s believed therapeutic mechanisms or address illness mechanisms not directly targeted by CBT. The discussion will end with clinical recommendations for CBT aftercare, such as monitoring and maintenance strategies to reduce relapse / recurrence risk and promote enduring mental health wellness beyond the immediate treatment period.