Cognitive Behavioral Group Therapy for Generalized Anxiety Disorder

Treatment

DIAGNOSIS: Generalized Anxiety Disorder

TREATMENT: Cognitive Behavioral Group Therapy for Generalized Anxiety Disorder

BRIEF SUMMARY

Basic premise: Generalized anxiety disorder (GAD) involves discomfort about life aspects such as world events, finances, health, appearance, family members, work, and school. Symptoms may include restlessness, fatigue, poor concentration, irritability, muscle tension, and disrupted sleep. Research indicates that Cognitive Behavioral Therapy (CBT) may effectively treat anxiety disorders including GAD.
Essence of therapy: Cognitive Behavioral Group Therapy (CBGT) as a treatment approach for Generalized Anxiety Disorder (GAD) uses evidence-based intervention methods delivered in a group setting. The main goal of CBGT is to address and modify maladaptive thought patterns, behaviors, and underlying cognitive processes associated with GAD to reduce psychological distress. This is achieved through the implementation of various techniques, including cognitive restructuring, behavioral strategies, and psychoeducation. CBGT empowers individuals to develop effective coping mechanisms, enhance problem-solving skills, challenge irrational beliefs, and improve their ability to regulate emotions. The group format of CBGT for GAD provides a supportive environment where participants can openly share their experiences, gain diverse perspectives, and receive valuable feedback from other participants. This group dynamic facilitates the therapeutic process and improves personal growth.

American Psychological Association. (n.d.). Generalized anxiety disorder. APA dictionary of psychology. https://dictionary.apa.org/obsessive-compulsive-disorder

Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A. J., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depression and Anxiety, 35(6), 502–514. https://doi.org/10.1002/da.22728

Cuijpers, P., Sijbrandij, M., Koole, S., Huibers, M., Berking, M., & Andersson, G. (2014). Psychological treatment of generalized anxiety disorder: A meta-analysis. Clinical Psychology Review, 34(2), 130–140. https://doi.org/10.1016/j.cpr.2014.01.002

Dugas, M. J., Ladouceur, R., Léger, E., Freeston, M. H., Langolis, F., Provencher, M. D., & Boisvert, J.-M. (2003). Group cognitive-behavioral therapy for generalized anxiety disorder: Treatment outcome and long-term follow-up. Journal of Consulting and Clinical Psychology, 71(4), 821–825. https://doi.org/10.1037/0022-006X.71.4.821

TREATMENT RESOURCES

TREATMENT MANUALS

Mastery of your anxiety and panic: Therapist guide (Barlow & Craske, 2022)

Generalized Anxiety Disorder, patient treatment manual. (Clinical Research Unit for Anxiety Disorders St. Vincent’s Hospital Sydney, 2010)

Cognitive-Behavioral Therapy (CBT) Basic Group for Anxiety (DeSana)

WORKBOOKS and WORKSHEETS

Mastery of Your Anxiety and Panic: Workbook (Barlow & Craske, 2006)

How to beat worry and generalised anxiety disorder one step at a time: Using evidence-based low-intensity CBT (Farrand & Chellingsworth, 2016)

Managing your worries. A Cognitive Behavioural Therapy evidence based approach to help you overcome your Generalised Anxiety (Farrand, Woodford, & Small, 2019)

Cognitive-behavioral treatment for generalized anxiety disorder: From science to practice (Robichaud & Dugas, 2006)

Generalized anxiety disorder workbook: CBT activities to manage anxiety, cope with uncertainty, and overcome stress (Shapiro, 2022)

CBT for worry and generalised anxiety disorder (Wilkinson, Meares, & Freeston, 2011)

Anxiety (Client Handouts) (University of Washington Harborview Center for Sexual Assault & Traumatic Stress)

Anxiety Handouts and Worksheets (Psychology Tools)

18 Anxiety Worksheets for Adults, Teens & More (Sutton, 2023)

ADDITIONAL RESOURCES

Generalized anxiety disorders (Van Ameringen & Pollack, 2011)

Generalized anxiety disorder: The CBT approach (The Washington Center for Cognitive Therapy, 2018)

Helpful Anxiety Resources (Anxiety & Depression Association of America)

Generalised Anxiety Disorder resources for clinicians (Centre for Clinical Interventions, 2023)

Generalized Anxiety Disorder and Worry. Resources and Support for You (Humber River Hospital, Mental Health and Addictions Program, 2017)

Self-help - Generalised anxiety disorder in adults (National Health Service)

Generalized anxiety disorder (GAD) treatment options (Tartakovskey & Arthur, 2021)

Generalized anxiety (GAD) (The Washington Center for Cognitive Therapy)

SUPPORTING STUDIES

Avdagic, E., Morrissey, S. A., & Boschen, M. J. (2014). A Randomised Controlled Trial of Acceptance and Commitment Therapy and Cognitive-Behaviour Therapy for Generalised Anxiety Disorder. Behaviour Change, 31(2), 110–130.

https://doi.org/10.1017/bec.2014.5

Davidson, J. R. T., Foa, E. B., Huppert, J. D., Keefe, F. J., Franklin, M. E., Compton, J. S., Zhao, N., Connor, K. M., Lynch, T. R., & Gadde, K. M. (2004). Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia. Archives of General Psychiatry, 61(10), 1005–1013.

https://doi.org/10.1001/archpsyc.61.10.1005

https://doi.org/10.1037/0022-006X.71.4.821

Erickson, D. H., Janeck, A. S., & Tallman, K. (2007). A cognitive-behavioral group for patients with various anxiety disorders. Psychiatric Services, 58(9), 1205–1211.

https://doi.org/10.1176/ps.2007.58.9.1205

Hui, C., & Zhihui, Y. (2017). Group cognitive behavioral therapy targeting intolerance of uncertainty: A randomized trial for older Chinese adults with generalized anxiety disorder. Aging & Mental Health, 21(12), 1294–1302.

https://doi.org/10.1080/13607863.2016.1222349

Norton, P. J. (2012). A Randomized Clinical Trial of Transdiagnostic Cognitive-Behavioral Treatments for Anxiety Disorder by Comparison to Relaxation Training. Behavior Therapy, 43(3), 506–517.

https://doi.org/10.1016/j.beth.2010.08.011

Simon, N. M., Hofmann, S. G., Rosenfield, D., Hoeppner, S. S., Hoge, E. A., Bui, E., & Khalsa, S. B. S. (2021). Efficacy of Yoga vs Cognitive Behavioral Therapy vs Stress Education for the Treatment of Generalized Anxiety Disorder: A Randomized Clinical Trial. JAMA Psychiatry, 78(1), 13–20.

https://doi.org/10.1001/jamapsychiatry.2020.2496

Stanley, M. A., Beck, J. G., & Glassco, J. D. (1996). Treatment of generalized anxiety in older adults: A preliminary comparison of cognitive-behavioral and supportive approaches. Behavior Therapy, 27(4), 565–581.

https://doi.org/10.1016/S0005-7894(96)80044-X

Stanley, M. A., Beck, J. G., Novy, D. M., Averill, P. M., Swann, A. C., Diefenbach, G. J., & Hopko, D. R. (2003). Cognitive-behavioral treatment of late-life generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 71(2), 309–319.

https://doi.org/10.1037/0022-006X.71.2.309

Wetherell, J. L., Gatz, M., & Craske, M. G. (2003). Treatment of generalized anxiety disorder in older adults. Journal of Consulting and Clinical Psychology, 71(1), 31–40.

https://doi.org/10.1037/0022-006X.71.1.31

White, J., Keenan, M., & Brooks, N. (1992). Stress Control: A Controlled Comparative Investigation of Large Group Therapy for Generalized Anxiety Disorder. Behavioural and Cognitive Psychotherapy, 20(2), 97–113.

https://doi.org/10.1017/S014134730001689X

White, J. (1997). “Stress control” large group therapy: Implications for managed care systems. Depression and Anxiety, 5(1), 43–45.

https://doi.org/10.1002/(SICI)1520-6394(1997)5:1<43::AID-DA9>3.0.CO;2-6

White, J. (1998). “Stress control” large group therapy for generalized anxiety disorder: Two Year Follow up. Behavioural and Cognitive Psychotherapy, 26(3), 237–245.

https://doi.org/10.1017/S1352465898000253

Wong, S. Y. S., Yip, B. H. K., Mak, W. W. S., Mercer, S., Cheung, E. Y. L., Ling, C. Y. M., Lui, W. W. S., Tang, W. K., Lo, H. H. M., Wu, J. C. Y., Lee, T. M. C., Gao, T., Griffiths, S. M., Chan, P. H. S., & Ma, H. S. W. (2016). Mindfulness-based cognitive therapy v. group psychoeducation for people with generalised anxiety disorder: Randomised controlled trial. The British Journal of Psychiatry, 209(1), 68–75.

https://doi.org/10.1192/bjp.bp.115.166124

Wuthrich, V. M., & Rapee, R. M. (2013). Randomised controlled trial of group cognitive behavioural therapy for comorbid anxiety and depression in older adults. Behaviour Research and Therapy, 51(12), 779–786.

https://doi.org/10.1016/j.brat.2013.09.002

Yang, Z.-H., & Wang, J.-P. (2011). Short-term group cognitive behavioral intervention in generalized anxiety individuals. Chinese Journal of Clinical Psychology, 19(5), 694-698.