Anxiety (Generalized Anxiety Disorder)

Overall Goal of Treatment

Although the treatment aims to achieve several therapeutic goals, the ultimate goal of our treatment is to help clients re-evaluate their catastrophic interpretations about uncertainty and its consequences.

This is accomplished by shifting their beliefs about the threat of uncertainty present in daily life situations from a series of negative beliefs to a more balanced perspective.

Research suggests that individuals with GAD tend to inflate the likelihood and severity of a negative outcome in novel, unpredictable, and ambiguous situations, underestimate their ability to cope with potential negative outcomes, and view the experience of uncertainty in daily life as unpleasant, unacceptable, and unfair.

Without a doubt, having the ability to view the uncertainty in various situations as normal, as often benign in its outcome, and as manageable, is incompatible with the excessive and uncontrollable worry seen in GAD.

One way to view worry is as an elaborate form of scenario building, where individuals mentally review every potential outcome of an uncertainty-inducing situation in order to control or be fully prepared for each outcome.

Worry can therefore be construed as an attempt to reduce or eliminate the state of uncertainty induced in a given situation. If individuals with GAD can shift their beliefs to view uncertainty as less threatening (and even embrace uncertainty on occasion), the extensive “mental preparation” of worry no longer becomes necessary. As such, helping clients to reevaluate and shift their negative beliefs about uncertainty is the overarching focus of the treatment.

With the primary focus of treatment in mind, therapy will target negative beliefs about uncertainty directly by helping clients to test out their beliefs through the use of behavioural experiments.

Clients are encouraged to recognize their own beliefs about the threat of uncertainty in daily life situations and to become familiar with the GAD-related safety behaviours they engage in as a consequence. These safety behaviours (e.g., reassurance seeking, over-preparation, avoidance) are then deliberately and strategically eliminated in order to observe in an experiential manner what actually occurs when uncertainty is invited into one’s life.