Clinical Psychology
Cognitive-Behavioral Therapy
CBT
- an effective treatment for GAD, typically leading to reductions in worry, and a
study has shown that such therapy is equal to pharmaceutical treatment and
more effective 6 months after study completion
- includes the development of a functional analysis, providing information
through psychoeducation, experimentation with new behaviors and emotions
(exposition, relaxation), and a cognitive approach
Functional analysis
- makes it possible to specify where, when, with what frequency, with what
intensity, and under what circumstances the anxious response is triggered
- makes it possible to visualize the mental functioning of the person
Psychoeducation
- the next step after functional analysis
- crucial because it makes it possible to understand what the future therapeutic
tools will be and facilitates the increase in motivation to change
- patients begin to think in a different way about which behaviors could be the
most useful for them
The emotional and behavioral approach
- generally favored approach
- the therapist tries to teach relaxation in order to instruct how to create positive
emotions, not to manage negative ones
- double effect
i) the provision of a “psychological tool” to prepare for exposition
exercises; relaxation allows desensitization of anxiogenic situations
ii) a balancing of the general mood by adding “cognitive break times” in
thoughts and worries
- the behavioral dimension of CBT is the most important
- patients will be able to expose themselves to their own emotions and so will be
able to learn how to fight maintaining factors and avoidance behaviors that
perpetuate the disorder
- the cognitive process that is sought is habituation, acceptance of thoughts as
normal and nonblocking that initiates cognitive work
, - an example of mental exposition is the instruction “think the worst”, this
strategy allows a rapid and effective reduction in avoidance
- exposure to anxiety allows patients to remain in the presence of images related
to their possible concerns (disturbing images that are usually avoided), in order
to encourage emotional habituation
- patients can learn to tolerate their fears, which will allow them to think less
often and less intensely about their worries
The cognitive approach
- begins with a self-observation that patients will carry out on their own thoughts
- the aim of the cognitive work is to help patients take a step back from their
automatic thoughts and to be disjointed from those worries, adopted by the
third wave in CBT (mindfulness) to create its therapeutic program with a
different form
- therapy tends to modify the content of thoughts to reach a more objective
evaluation of situations
- the goal is to struggle against cognitive biases, such as overgeneralization or
maximization of danger
- a second evaluation of situations is possible by looking for objective indicators
that allow relativizing, it is also possible to evaluate the consequences of worry
and to understand subtle avoidance
GAD
- the presence of excessive anxiety and worry about a variety of topics, events,
or activities (main symptom)
- the search for reassurance is the second core element
- worry occurs more often than not for at least 6 months
- edginess or restlessness, difficulty sleeping, difficulty concentrating, and an
increase in muscle aches or soreness
- had been considered an “anxiety neurosis”
- factors common to anxiety disorders; anxious anticipation, cognitive biases,
and excessive concern
- specific factors that are not shared with other anxiety disorders; intolerance of
uncertainty, and excessive concerns in several important areas
- affects 6% of the general population if one considers the entire lifespan
- associated functional impairment is similar to that observed with major
depression
- in 60% of cases, major depression or another anxious disorder is present
- 90% of GAD sufferers are suspected to have a secondary anxious disorder,
such as social anxiety or panic disorder
Cognitive-Behavioral Therapy
CBT
- an effective treatment for GAD, typically leading to reductions in worry, and a
study has shown that such therapy is equal to pharmaceutical treatment and
more effective 6 months after study completion
- includes the development of a functional analysis, providing information
through psychoeducation, experimentation with new behaviors and emotions
(exposition, relaxation), and a cognitive approach
Functional analysis
- makes it possible to specify where, when, with what frequency, with what
intensity, and under what circumstances the anxious response is triggered
- makes it possible to visualize the mental functioning of the person
Psychoeducation
- the next step after functional analysis
- crucial because it makes it possible to understand what the future therapeutic
tools will be and facilitates the increase in motivation to change
- patients begin to think in a different way about which behaviors could be the
most useful for them
The emotional and behavioral approach
- generally favored approach
- the therapist tries to teach relaxation in order to instruct how to create positive
emotions, not to manage negative ones
- double effect
i) the provision of a “psychological tool” to prepare for exposition
exercises; relaxation allows desensitization of anxiogenic situations
ii) a balancing of the general mood by adding “cognitive break times” in
thoughts and worries
- the behavioral dimension of CBT is the most important
- patients will be able to expose themselves to their own emotions and so will be
able to learn how to fight maintaining factors and avoidance behaviors that
perpetuate the disorder
- the cognitive process that is sought is habituation, acceptance of thoughts as
normal and nonblocking that initiates cognitive work
, - an example of mental exposition is the instruction “think the worst”, this
strategy allows a rapid and effective reduction in avoidance
- exposure to anxiety allows patients to remain in the presence of images related
to their possible concerns (disturbing images that are usually avoided), in order
to encourage emotional habituation
- patients can learn to tolerate their fears, which will allow them to think less
often and less intensely about their worries
The cognitive approach
- begins with a self-observation that patients will carry out on their own thoughts
- the aim of the cognitive work is to help patients take a step back from their
automatic thoughts and to be disjointed from those worries, adopted by the
third wave in CBT (mindfulness) to create its therapeutic program with a
different form
- therapy tends to modify the content of thoughts to reach a more objective
evaluation of situations
- the goal is to struggle against cognitive biases, such as overgeneralization or
maximization of danger
- a second evaluation of situations is possible by looking for objective indicators
that allow relativizing, it is also possible to evaluate the consequences of worry
and to understand subtle avoidance
GAD
- the presence of excessive anxiety and worry about a variety of topics, events,
or activities (main symptom)
- the search for reassurance is the second core element
- worry occurs more often than not for at least 6 months
- edginess or restlessness, difficulty sleeping, difficulty concentrating, and an
increase in muscle aches or soreness
- had been considered an “anxiety neurosis”
- factors common to anxiety disorders; anxious anticipation, cognitive biases,
and excessive concern
- specific factors that are not shared with other anxiety disorders; intolerance of
uncertainty, and excessive concerns in several important areas
- affects 6% of the general population if one considers the entire lifespan
- associated functional impairment is similar to that observed with major
depression
- in 60% of cases, major depression or another anxious disorder is present
- 90% of GAD sufferers are suspected to have a secondary anxious disorder,
such as social anxiety or panic disorder
