For some people, major decisions, such as accepting a job offer, and even minor ones, like deciding where to have dinner, can be extremely difficult. The individual may get "stuck" and feel completely unable to make a decision. He may develop the belief that he is incapable of making decisions or solving problems. The person may avoid decision-making whenever possible, letting others make important decisions or postponing decisions for long periods of time, sometimes even years. This passivity can contribute to an unsatisfying, unrewarding life, can cause the person to feel ineffective, and may place him or her at risk for becoming depressed or developing an anxiety disorder.
Cognitive-behavior therapy helps the fearful decision-maker take an active stance toward life by teaching skills to generate and evaluate alternatives to problems and to choose and implement concrete solutions to those problems. Therapy also helps the person identify and test maladaptive cognitions about decision-making, such as, "If I make the wrong decision, something really bad will happen and I won't be able to cope with it." Therapy can enable the anxious decision-maker to acquire skills and confidence in making decisions and solving problems that can be maintained well into the future.