Exploring change in cognitive-behavioral therapy for generalized anxiety disorder—A two-arms ABAB crossed-therapist randomized clinical implementation trial.

Christoph Flückiger*, Andreea Vîslă, Christine Wolfer, Peter Hilpert, Richard E. Zinbarg, Wolfgang Lutz, Martin grosse Holtforth, Mathias Allemand

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: There is little evidence-based knowledge of how psychotherapists should handle both sudden gains and more gradual session-by-session changes, either in general or in individuals suffering from generalized anxiety disorder. Methods: Using an ABAB crossed-therapist randomized clinical implementation trial design (N = 80 patients and 20 therapists), we contrasted a Prolonged Focus on Change (PFC, N = 40) implementation with a State-Of-The-Art (SOTA, N = 40) implementation. Both implementations were based on a widely used cognitive behavioral therapy approach (Mastery of your Anxiety and Worry package) with the only difference that in the PFC implementation, the therapists were instructed to systematically explore eventual changes at the beginning of the therapy sessions. Results: Based on a 3-level hierarchical linear model, PFC implementation showed faster symptom reduction in worry over therapy (i.e., linear change) and a decelerated (quadratic) change until 12-month follow-up in comparison to the SOTA implementation. Conclusion: These findings provide clinically useful information about potential short-term and long-term effects of exploring occurring change in GAD populations. Randomized clinical implementation trial designs are a step forward allowing to experimentally investigate basic psychotherapeutic strategies in process-based psychotherapy. (PsycInfo Database Record (c) 2021 APA, all rights reserved) This randomized clinical implementation trial provides empirical evidence for good clinical wisdom that exploring occurring change is helpful to facilitate further change during therapy. These results underscore the relevance of understanding patient’s proactive engagement in change behaviors, competences, skills, and behavioral preferences in individuals that suffer from generalized anxiety disorder to positively impact worry outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Original languageEnglish (US)
Pages (from-to)454-468
Number of pages15
JournalJournal of Consulting and Clinical Psychology
Volume89
Issue number5
DOIs
StatePublished - Apr 8 2021

Keywords

  • generalized anxiety disorder
  • prolonged focus on change
  • sudden gains

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Fingerprint

Dive into the research topics of 'Exploring change in cognitive-behavioral therapy for generalized anxiety disorder—A two-arms ABAB crossed-therapist randomized clinical implementation trial.'. Together they form a unique fingerprint.

Cite this