Cognitive Behaviour Therapy

Based on the research there seems to be a general consensus that CBT is an effective approach for the psychological treatment of GAD. It has been the most researched and is considered to be the most widely used as an initial approach, (Borkovec, Newman & Castonguay, 2003), (Erickson & Newman, 2005)

According to Durham and Fisher (2007), (up to that time) there had been 30 clinical trials based on DSM diagnostic criteria, the main focus of which was CBT. Newman, (2000), reported that from this research the outcome showed that only 50% of clients with GAD experienced a reduction in symptoms, when compared to non-diagnosed individuals.

The first research trials to asses the effectiveness of CBT for the treatment of GAD included early studies from (Barlow et al., 1984; Barlow, Rapee & Brown, 1992; Blowers, Cobb & Mathews, 1987; Butler, Cullington, Hibbert, Klimes & Gelder, 1987; Lindsay, McLaughlin, Hood, Espie & Gamsu, 1987) and combined relaxation therapy (RT), Anxiety management packages, with a mixture of cognitive therapy (CT) behaviour therapy (BT) and cognitive behaviour therapy.

The studies demonstrated greater improvement compared to a non-directive approach. Two studies by Borkovec et al., (1987, and Butler, Fennell, Robson & Gelder (1991), concluded that CBT was more effective than BT. Chambers and Gillis (1993) in a seven-study meta-analysis reported that CBT was substantially more effective than a wait list or placebo.

A study by Dugas et al., (2003) produced the following outcomes. Treatment was applied to group cognitive behaviour therapy. There were 5-6 groups with 4-6 participants with a total of 52 clients diagnosed with GAD. The treatment was for 14 weekly 2-hour sessions managed by two clinical psychologists. The percentage of clients who no longer met the criteria for GAD were 60% at post, 88% at 6 months, 83%, at 12 months and increased to 95% at a 2 year follow up.

In summary, researchers have confirmed that CBT is an effective and valid treatment approach for reducing pathological worry and somatic symptoms of GAD. In saying this there is still a percentage of clients with GAD who do not seem to benefit from what may be considered the most effective treatment.

In the next part of the review I will explore other possibilities for psychosocial treatments for GAD that attempt to stand alone or are combined with CBT.