Cognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD)

Cognitive-behavioral therapy (CBT) fundamentally aims to ameliorate generalized anxiety disorder (GAD) symptoms, which stem from habitual, inflexible, and spiraling systems of interaction between somatic, cognitive, and emotional responses to appraised threats. This chapter describes the core components of CBT often employed in clinical trials of GAD based on established manuals as well as recent treatment packages for GAD based on a CBT rationale such as metacognitive therapy, intolerance-of-uncertainty therapy, or emotion-regulation therapy. It discusses the implementation of CBT by including self-monitoring, relaxation training, progressive muscle relaxation, imagery training, meditation, applied relaxation, self-control desensitization, stimulus control, worry exposure, and cognitive restructuring. Several studies have examined predictors of treatment outcome for GAD. Anxiety severity at baseline predicted higher severity post-treatment as well as poorer follow-up outcomes 10 to 14 years post-treatment.