General Anxiety Disorder (GAD)

Cognitive Behavioural Therapy for Generalized Anxiety Disorder (GAD)

Module Overview:

This module covers Generalized Anxiety Disorder, both the cognitive and behavioral mechanisms that underpin the disorder and equips the participant with the advanced level skills in CBT for GAD. GAD represents a significant problem comprising excessive and uncontrollable worry that interferes with daily functioning, making it an important focus for effective intervention.

Participants will learn how to incorporate updated cognitive models, such as the intolerance of uncertainty framework by Michel J Dugas, and evidence-based  treatment techniques inspired by David Clark, focusing on metacognitive processes, worry management, and adaptive behavioral strategies. It also integrates recent research findings, such as the advances in cognitive-behavioral techniques to improve treatment outcomes. This module provides a review of recent research, novel interventions, and practical approaches specific to the challenges presented by GAD.

This module will equip participants, through a combination of workshops, clinical supervision, and practical exercises, to deliver evidence-based interventions that address these complex features of GAD: excessive worry, avoidance behaviors, and somatic symptoms.

Module Aims

This module aims to:

Provide an in-depth understanding of GAD's core features, cognitive mechanisms, and associated behaviors.

Develop advanced competencies in CBT approaches tailored to GAD with a special emphasis on intolerance of uncertainty and metacognitive interventions.

Enhance the development and implementation of individualized treatment plans for clients with GAD.

Equip participants with skills to address comorbid conditions such as depression  within the context of GAD.

Learning Outcomes

Specific Skills

At the end of this module, participants will be able to:

Describe the phenomenology, diagnostic criteria and epidemiology of GAD.

Critically review the cognitive models of GAD, including intolerance of uncertainty, Dugas and metacognitive approaches, Clark.

Devise individualised CBT treatment plans targeting excessive worry and avoidance.

Engage in high-level interventions: worry postponement, problem-solving strategies and behavioral experiments.

Formulate and implement co-occurring conditions such as depression and other anxieties.

Professional Skills

Modify evidence-based CBT techniques to appeal to the unique needs and preferences of a client.

Utilise contemporary findings to inform GAD clinical practice.

Reflect upon therapeutic skills utilized and identify avenues for growth in delivering CBT for GAD.

Personal and Key Skills

Communicate effectively about the theoretical and practical aspects of GAD treatment.

Establish practical coping strategies with the client that will maintain worry within manageable limits and, if possible, avoid triggers.

Module Content

Introduction to Generalized Anxiety Disorder

Definition and key features: chronic tension and restlessness, persistent and pervasive worry.

Diagnosis (ICD-11/DSM-5) and diagnostic differentials for GAD.

Epidemiological trends and cultural considerations in GAD presentations.

Cognitive and Behavioral Models

Dugas' Intolerance of Uncertainty Model:

Highly structured and practical approach to reduce the degrees to which intolerance of uncertainty perpetuate cycles of worry.

Strategies to help clients tolerate uncertainty and reduce avoidance.

Clark’s Metacognitive Model:

Cognitive restructure to reduce anxious thoughts and changing beliefs about worry (e.g., that worry is uncontrollable or helpful)Understanding worry as a coping mechanism for perceived threats.

Identifying and modifying positive and negative metacognitive beliefs.

Advanced Interventions for GAD

Worry Postponement: Helping clients schedule worry time and redirect focus.

Problem-Solving Therapy: Teaching structured approaches to address solvable problems.

Behavioral Experiments: Testing catastrophic predictions to reduce avoidance.

Relaxation Techniques: Managing somatic symptoms through applied relaxation.

Co-Occurring Disorders

Management of comorbid symptoms of depression in patients with GAD.

Ways to integrate GAD treatment for such comorbidities.

5. Risk Management and Relapse Prevention

Identifying high-risk factors involved in the maintenance and recurrence stages of GAD.

Developing relapse prevention plans with emphasis on the maintenance of skills.

Teaching Methodology

Workshops: Interactive training workshops on GAD-specific CBT skills.

Supervision: Clinical practice under tutor guidance.

Case Studies: Review and discussion of real cases related to GAD to enhance application skills.

Role-plays: Sessions of practice for building therapeutic competencies.

 

Assessment

Assessment will be through:

Case conceptualization assignments that demonstrate understanding of the cognitive and behavioral mechanisms of GAD; recorded therapy sessions with reflective commentary; active participation in discussions, workshops, and skill-building exercises.

Recommended Reading and Resources

A comprehensive list of references will be provided in the course handouts and will be shared with participants upon registration.