The Talking Cure”
Psychotherapy is a popular form of treatment for generalized anxiety disorder(GAD). This type of treatment can be performed by a variety of mental health professionals. Though “talk therapies” share a number of features, different approaches are guided by differing theories and emphases.
The following is a brief description of the most popular talk therapy treatment methods for GAD.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a present-focused psychotherapy commonly used in the treatment of anxiety disorders, mood disorders, and eating disorders. CBT sessions are typically structured and focus on the interplay between the conscious thoughts, feelings, and behaviors that perpetuate anxiety. CBT is generally a short-term treatment that aims to teach the patient how to become his or her own therapist, but the course of treatment can be longer (or can include “booster” sessions in which certain skills are refreshed) if symptoms tend to wax and wane over time.
Research has determined that CBT can produce reliable and significant improvement in GAD symptoms by the end of therapy, and progress can often be maintained after treatment ends. This type of treatment has also been proven effective for children and adolescents with anxiety disorders. CBT has been associated with a reduction in the need for medications in some people.
Acceptance and Committment Therapy
Acceptance and commitment therapy (ACT) is another present- and problem-focused talk therapy. In contrast with CBT (which provides strategies to challenge and thereby reduce problematic thoughts and behaviors), the ACT approach focuses – as the name implies – on acceptance. Overall, this type of therapy encourages gaining insight into patterns of thinking, patterns of avoidance, and the presence or absence of action that is in line with chosen life values. The goal is to reduce your struggle to control or do away with these experiences and simultaneously to increase involvement in meaningful life activities (i.e., those activities that are consistent with personal values).
Research has shown that ACT can produce symptom improvement in people with GAD, and it may also be a particularly good fit for older adults.
For more information about ACT, see this detailed overview.
Psychodynamic psychotherapy is based on the idea that thoughts and feelings that are outside of our awareness (unconscious) can lead to inner conflicts and might manifest as problems with anxiety or mood. Psychodynamic psychotherapy sessions are not structured and because people are encouraged to speak as freely as possible in order to become aware of their unconscious, both the present and the past are likely to be discussed. Traditionally, psychodynamic therapy is carried out over a long period of time.
While individual patients may find this form of therapy to be helpful in reducing anxiety symptoms, because of the duration and unstandardized nature of this approach there has been little research about its effects on reducing GAD symptoms. However, more recently, there have been promising findings for a manualized adaptation of this type of approach – short-term psychodynamic therapy – in successfully treating GAD.
Interpersonal psychotherapy (IPT) is a time-limited, present-focused treatment originally designed to treat depression. It is based on the assumption that symptoms may be caused or perpetuated by problems in relationships, and that resolving these problems can help reduce symptoms. Within an IPT frame, an individual would focus on a few, select relationship issues. IPT can be delivered in a one-on-one or group format.
Among other techniques, communication skills are taught and practiced during sessions. Individuals may be asked to role-play and bring these skills to their outside life between sessions to improve interpersonal effectiveness.
Though there have been some trials of IPT in anxiety disorders, it does not seem to have clear advantages relative to other approaches. However, for people with co-occurring depression and GAD, IPT may be an appropriate therapy to try.