Cognitive-Behavioral Treatment for Generalized Anxiety Disorder: Theoretical Foundations and Empirically Supported Strategies

摘要

Cognitive-behavioral therapy (CBT) is the most extensively studied psychotherapy for generalized anxiety disorder (GAD) and has demonstrated large effect sizes compared to waitlist and placebo control. CBT for GAD treatment protocols is based on several cognitive-behavioral models of the disorder that emphasize the role of worry as an avoidance strategy to escape from distressing internal experiences, such as negative emotions, uncomfortable physical sensations, and intrusive images. Cognitive-behavioral models also posit that positive and negative beliefs about worry are instrumental in maintaining the worry process. Common cognitive-behavioral treatment strategies to target these causal mechanisms include psychoeducation, self-monitoring of worry episodes, relaxation techniques, mindfulness exercises, cognitive reappraisal, behavioral experiments to test beliefs about worry, imaginal exposure to core fears, and commitment to valued actions. In this article, we provide an overview of cognitive-behavioral models of GAD and describe the evidence-based treatment strategies that emerged from these models.