Psychological Approaches to Generalized Anxiety Disorder: A Clinician's Guide to Assessment and Treatment / Edition 1

Psychological Approaches to Generalized Anxiety Disorder: A Clinician's Guide to Assessment and Treatment / Edition 1

by Holly Hazlett-Stevens
     
 

ISBN-10: 0387768696

ISBN-13: 9780387768694

Pub. Date: 08/12/2008

Publisher: Springer US

One of the hallmarks of generalized anxiety disorder, along with diffuse pathological worry and somatic complaints, is its resistance to therapy. Of available treatment modalities for GAD, cognitive-behavioral therapy garners the best empirical support in terms of successful long-term results. Psychological Approaches to Generalized Anxiety Disorder offers clinicians…  See more details below

Overview

One of the hallmarks of generalized anxiety disorder, along with diffuse pathological worry and somatic complaints, is its resistance to therapy. Of available treatment modalities for GAD, cognitive-behavioral therapy garners the best empirical support in terms of successful long-term results. Psychological Approaches to Generalized Anxiety Disorder offers clinicians a wide variety of CBT strategies to help clients develop core anxiety-reduction skills, presented so that readers can hone their own clinical skills. Concise without skimping on information, this book reviews current theory and research, addresses important diagnostic issues, and provides salient details in these key areas: Assessment procedures and treatment planning. Latest therapy outcome data, including findings on newer therapies. Specific CBT techniques, including cognitive strategies, psychoeducation, anxiety monitoring, relaxation exercises, and more. Dealing with noncompliance, client ambivalence, and other challenges to therapy. Special considerations for treating older adults with GAD. Relapse prevention, transition issues, and ending treatment.

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Product Details

ISBN-13:
9780387768694
Publisher:
Springer US
Publication date:
08/12/2008
Series:
Series in Anxiety and Related Disorders
Edition description:
2008
Pages:
190
Product dimensions:
6.20(w) x 9.30(h) x 0.60(d)

Table of Contents

1 Diagnosis, Clinical Features, and Theoretical Perspectives 1

Generalized Anxiety Disorder Diagnosis 2

History of GAD Diagnosis 2

Current GAD Diagnostic Definition 3

Epidemiology and Related Statistics 4

Prevalence and Course 4

Demographic Features 6

Comorbid Conditions 7

Current Theoretical Approaches 8

An Integrative Theoretical Model of GAD 8

Avoidance Theory of Worry and GAD 9

Chapter Summary 11

2 GAD Treatment Research 13

Initial GAD Psychotherapy Outcome Research 14

Study Characteristics 14

Sample Characteristics and Treatment Features 14

Treatment Outcome Results 15

Summary of Preliminary Research Findings 16

Cognitive-Behavioral and Pharmacological Treatment Research 17

Inclusion Criteria and Methodological Considerations 17

CBT Outcome Results 17

Pharmacotherapy Outcome Results 18

Comparisons Between CBT and Pharmacological Treatments 18

Recent GAD Treatment Outcome Meta-Analysis Results 19

Updated Psychotherapy Outcome Meta-Analytic Review Results 19

Updated CBT Meta-Analytic Review Results 20

Additional GAD Treatment Research 21

Component Analysis of CBT for GAD 22

Comparisons Between Applied Relaxation and Cognitive Therapy 22

Summary of Recent Research Findings and Future Directions 23

GAD Treatment for Older Adults 24

Early Psychotherapy Outcome Research 24

GAD Psychotherapy Outcome Research 25

Other Treatment-Related research 26

Chapter Summary 27

3 Assessment Procedures and Treatment Planning 29

Diagnostic Assessment 29

Diagnostic Considerations 30

Unstructured Intake Interview Approach 32

Semi-Structured Diagnostic Interviews 33

Structured Diagnostic Interviews 35

Brief DiagnosticAssessment Measures 35

Summary and Conclusions 37

Assessment of Worry and Related Constructs 38

Worry Severity 39

Worry Content 41

Meta-Worry 42

Worry Beliefs 43

Other Meta-Cognitive Constructs 45

Intolerance of Uncertainty 47

Summary and Conclusions 48

Assessment of Older Adults 49

Examination of Existing Measures 49

Assessment Measures Developed for Older Adults 49

Treatment Planning 50

Idiosyncratic Symptom, Cognitive, and Behavioral Features 50

Interpersonal Problems and Social Support 51

Medical Problems and Conditions 52

Disability, Impairment, and Quality of Life Interference 53

Treatment Plan Construction 53

Chapter Summary 54

4 Psychoeducation and Anxiety Monitoring 59

Psychoeducation 61

GAD Information 61

Causes of GAD 62

Cognitive-Behavioral Model of GAD 63

Definitions of Fear, Anxiety, and Worry 65

CBT Treatment Rationale 66

Role of the Client in the Therapy Process 67

Style of Presentation 68

Anxiety Monitoring 70

Self-Monitoring Rationale 73

Within-Session Modeling of Frequent Monitoring 73

Self-Monitoring Homework Instructions 78

Chapter Summary 79

5 Relaxation Strategies 81

Diaphragmatic Breathing 84

Diaphragmatic Breathing Rationale 84

Diaphragmatic Breathing Session Procedures 85

Optional Alternative Procedure for Panic Symptoms 88

Diaphragmatic Breathing Home Practice 88

Progressive Relaxation Training 90

Progressive Relaxation Training Rationale 91

Initial Progressive Relaxation Training Session Procedures 92

Initial Progressive Relaxation Home Practice 95

Subsequent Progressive Relaxation Training Procedures 96

Alternative Progressive Relaxation Training Procedures 98

Imagery Relaxation Training 99

Imagery Relaxation Rationale 99

Imagery Relaxation Session Procedures 100

Imagery Relaxation Home Practice 101

Combining Relaxation Techniques 101

Applying Relaxation Techniques 102

Relaxation Coping Responses 103

Relaxation Reminder Cues 104

Daily Brief Relaxation Practice 104

Chapter Summary 105

6 Cognitive Strategies 107

Initial Cognitive Therapy Procedures 109

Cognitive Therapy Rationale 109

Identify Specific Anxious Thoughts 111

Thought Tracking 112

Worry Postponement 115

Specific Cognitive Techniques to Challenge Anxious Thoughts 117

Generating Alternative Interpretations or Predictions 118

Examining the Likelihood and Evidence 119

Decatastrophizing 122

Core Beliefs About the Self, the World, and the Future 126

Common Core Beliefs 126

Identifying and Examining Core Beliefs 128

Additional Strategies for Restructuring Core Beliefs 131

Meta-Cognitive Worry Beliefs 132

Positive Worry Beliefs 133

Negative Worry Beliefs 135

Establishing New Perspectives 136

Developing New Perspectives 137

Constructing Preventive Beliefs 137

Application of Cognitive Strategies 138

Chapter Summary 138

7 Behavior Therapy and Exposure Strategies 141

Active Avoidance: Worry Safety Behavior 142

Identifying Worry Safety Behavior 142

Eliminating Worry Safety Behavior 143

Passive Avoidance Behavior 145

Identifying Passive Avoidance Behavior 146

Eliminating Passive Avoidance Behavior with Exposure Assignments 147

Imagery Exposure and Coping Rehearsal 149

Selecting Imagery Exposure Scenes 151

Conducting Imagery Exposure 152

Lifestyle Behavior Change 153

Identifying Neglected Activities 153

Increasing Engagement in Desired Activities 154

Chapter Summary 155

8 Common Problems and Clinical Considerations 157

Poor Compliance with Home Assignments 157

Low Motivation to Participate in Treatment 158

Practical Problems Completing Home Assignments 159

Fear that Homework Will Increase Anxiety and Worry 159

Problems in the Therapeutic Relationship 160

Common Problems Associated with Specific CBT Strategies 160

Relaxation Strategies 161

Cognitive Strategies 162

Behavior Therapy and Exposure Techniques 165

Therapy Termination and Relapse Prevention 166

Review of Client Progress and Essential Information 166

Continued Practice of Therapy Skills and Coping Responses 167

Written Relapse Prevention Plans 167

Early Termination of Therapy 168

Chapter Summary 169

References 171

Index 185

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