An Acceptance-Based Behavioral Therapy for Individuals with Generalized Anxiety Disorder

Acceptance and commitment therapy and its unacknowledged influences: Some old wine in a new bottle?

Recently, Goldfried suggested that one main reason for the underdevelopment of psychotherapy as a scientific enterprise was the lack of acknowledgment of past contributions. In this article, this issue is illustrated by analysing the particular case of acceptance and commitment therapy (ACT). ACT has clear overlaps with therapies from the systemic tradition, such as strategic therapy in the line of the Mental Research Institute in Palo Alto and with the more recent models of solution-focused therapy and narrative therapy. This article analyses theoretical overlaps with these models (e.g. the paradoxical nature of human problems and the nature of language) as well as examples of similarities in therapeutic strategies (externalization and the miracle question). It concludes by suggesting that this practice of inadvertently obliterating the past does not favour the development of the field or the creation of consensus but rather contributes to the ongoing proliferation of 'new' psychotherapy models. Trends that may contribute to circumventing this problem are discussed.

Neuro magnifico! An exploratory study critically reviewing news text reporting of anxiety-related work performance strengths, challenges and support measures

BACKGROUND

Progressive workplaces should be aware of emerging neurodiversity related issues. People are sharing their narratives of high functioning anxiety in a variety of forums. Despite news text reporting upon this phenomenon, the concept has managed to escape a research spotlight.

OBJECTIVE

To critically investigate the evidence base of news article reporting of anxiety-related work performance strengths, challenges and support measures.

METHODS

Thematic analysis was applied to news texts derived from CrossSearch database and internet enquiries and journal articles obtained from Scopus, Medline and Science Direct databases.

RESULTS

The analysis of eight news texts and 36 journal articles produced evidence-based themes including those of work performance strengths (quality, quantity, creativity) challenges (overreaching, perfectionism, overthinking, communication) and support measures (medical, cognitive, physical, flexibility).

CONCLUSION

This investigative review reveals that anxiety-related work performance strengths, challenges and support measures as identified within news text reporting of the high functioning anxiety concept have at least some basis in the literature. It might therefore be the case that organizations who invest in supporting employees who identify with high functioning dimensions of their anxiety disorders are the ones who are ultimately rewarded with work performance advantages.

Mechanisms of Change During Attention Training and Mindfulness in High Trait-Anxious Individuals: A Randomized Controlled Study

The first aim of this study was to compare attention manipulation techniques deriving from metacognitive therapy (the Attention Training Technique; ATT) and mindfulness-based approaches (Mindfulness-Based Progressive Muscle Relaxation, MB-PMR) to a thought wandering control (TWC) condition, in terms of their impact on anxiety and four mechanisms: distancing, present-focused attention, uncontrollability and dangerousness, metacognitive beliefs, and cognitive flexibility (Stroop task). The second aim was to test indirect effects of the techniques on anxiety via the mechanism measures. High trait anxious participants (N = 81, M_age = 23.60, SD_age = 7.66, 80% female) were randomized to receive ATT, MB-PMR, or the TWC condition. Measures of cognitive and somatic anxiety, distancing, present-focused attention, metacognitive beliefs, and cognitive flexibility were administered before or after the attention manipulation task. Compared to the TWC group, ATT and MB-PMR were associated with greater changes on cognitive (but not somatic) anxiety, present-focused attention, metacognitive beliefs, and uncorrected errors for threat-related words on the Stroop task. The pattern of means was similar for distancing, but this did not reach statistical significance, and Stroop speed increased equally for all conditions. Indirect effects models revealed significant effects of condition on state anxiety via distancing, metacognitive beliefs, and present-focused attention, but not via Stroop errors. ATT and MB-PMR were associated with changes on anxiety and the mechanism measures, suggesting that the mechanisms of change may be more similar than different across these techniques.

The new transdiagnostic cognitive behavioral treatments: Commentary for clinicians and clinical researchers

Recognition of the limitations of the current categorical diagnostic system and increased understanding of commonalities across clinical problems associated with negative emotion, including anxiety and depression, has led to the development of transdiagnostic psychological interventions. This new approach holds promise in shifting our emphasis from diagnostic categories to treating core construct that cut across disorders. This paper identifies some of the similarities and differences across various cognitive-behavioral transdiagnostic protocols and key challenges in assessment and case conceptualization for clinicians wishing to use this approach. Some key needs in the research literature that would be particularly helpful to clinicians are also identified.

Emotion Regulation Therapy for Generalized Anxiety Disorder

Despite the success of cognitive behavioral therapies (CBT) for emotional disorders, a sizable subgroup of patients with complex clinical presentations, such as patients with generalized anxiety disorder, fails to evidence adequate treatment response. Emotion Regulation Therapy (ERT) integrates facets of traditional and contemporary CBTs, mindfulness, and emotion-focused interventions within a framework that reflects basic and translational findings in affect science. Specifically, ERT is a mechanism-targeted intervention focusing on patterns of motivational dysfunction while cultivating emotion regulation skills. Open and randomized controlled psychotherapy trials have demonstrated considerable preliminary evidence for the utility of this approach as well as for the underlying proposed mechanisms. This article provides an illustration of ERT through the case of "William." In particular, this article includes a case-conceptualization of William from an ERT perspective while describing the flow and progression of the ERT treatment approach.

A contemporary view of applied relaxation for generalized anxiety disorder

Applied relaxation (AR), originally developed by Lars-Göran Öst, is a long-standing, efficacious treatment for generalized anxiety disorder (GAD). While newer treatments are continuing to be developed, AR remains one of the most efficacious treatments for GAD. However, AR has received less in-depth attention more recently, particularly in terms of potential mechanisms of action. This article is written to honor the development and history of AR and to highlight the ways that it has continued to be adapted. In this article, AR treatment strategies are presented, which include: noticing early signs of anxiety, learning relaxation skills, and applying relaxation at the first sign of anxiety. Then, additional adaptations to AR are presented along with recommendations of how AR may be enhanced by understanding potential mechanisms of change. Finally, recommendations are made for the continued evolution of AR as a powerful and efficacious treatment for GAD.