A Randomized Controlled Trial of Cognitive-Behavioral Therapy for Generalized Anxiety Disorder with Integrated Techniques from Emotion-Focused and Interpersonal Therapies

Newman, M.G., Castonguay, L.G. Borkovec, T.D., et al. (2011). A randomized controlled trial of cognitive-behavioral therapy for GAD with integrated techniques from emotion-focused and interpersonal therapies. Journal of Consulting and Clinical Psychology, 79(2), 171-181. doi:10.1037/a0022489

11 Pages Posted: 29 Jan 2015 Last revised: 8 May 2019

See all articles by Michelle G. Newman

Michelle G. Newman

Pennsylvania State University - Department of Psychology

Louis G. Castonguay

Pennsylvania State University - Department of Psychology

Thomas Borkovec

Pennsylvania State University

Aaron Fisher

University of California, Berkeley

James Boswell

University of Albany

Lauren Szkodny

Pennsylvania State University

Samuel Nordberg

Pennsylvania State University

Date Written: 2011

Abstract

Recent models suggest that generalized anxiety disorder (GAD) symptoms may be maintained by emotional processing avoidance and interpersonal problems.

METHOD: This is the first randomized controlled trial to test directly whether cognitive-behavioral therapy (CBT) could be augmented with the addition of a module targeting interpersonal problems and emotional processing. Eighty-three primarily White participants (mean age = 37) with a principle diagnosis of GAD were recruited from the community. Participants were assigned randomly to CBT plus supportive listening (n = 40) or to CBT plus interpersonal and emotional processing therapy (n = 43) within a study using an additive design. Doctoral-level psychologists with full-time private practices treated participants in an outpatient clinic. Using blind assessors, participants were assessed at pretreatment, posttreatment, 6-month, 1-year, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (the Penn State Worry Questionnaire; T. J. Meyer, M. L. Miller, R. L. Metzger, & T. D. Borkovec, 1990; Hamilton Anxiety Rating Scale; M. Hamilton, 1959; assessor severity rating; State-Trait Anxiety Inventory-Trait Version; C. D. Spielberger, R. L. Gorsuch, R. Lushene, P. R. Vagg, & G. A. Jacobs, 1983) as well as with indices of clinically significant change.

RESULTS: Mixed models analysis of all randomized participants showed very large within-treatment effect sizes for both treatments (CI = [-.40, -.28], d = 1.86) with no significant differences at post (CI = [-.09, .07], d = .07) or 2-year follow-up (CI = [-.01, .01]), d = .12). There was also no statistical difference between compared treatments on clinically significant change based on chi-square analysis.

CONCLUSIONS: Interpersonal and emotional processing techniques may not augment CBT for all GAD participants. Trial Registry name: Clinical Trials.gov, Identifier: NCT00951652.

Keywords: generalized anxiety disorder, psychotherapy, cognitive behavioral therapy, integrative therapy, GAD, interpersonal problems, emotion regulation

Suggested Citation

Newman, Michelle G. and Castonguay, Louis G. and Borkovec, Thomas and Fisher, Aaron and Boswell, James and Szkodny, Lauren and Nordberg, Samuel, A Randomized Controlled Trial of Cognitive-Behavioral Therapy for Generalized Anxiety Disorder with Integrated Techniques from Emotion-Focused and Interpersonal Therapies (2011). Newman, M.G., Castonguay, L.G. Borkovec, T.D., et al. (2011). A randomized controlled trial of cognitive-behavioral therapy for GAD with integrated techniques from emotion-focused and interpersonal therapies. Journal of Consulting and Clinical Psychology, 79(2), 171-181. doi:10.1037/a0022489. Available at SSRN: https://ssrn.com/abstract=2556471

Michelle G. Newman (Contact Author)

Pennsylvania State University - Department of Psychology ( email )

University Park, PA
United States

Louis G. Castonguay

Pennsylvania State University - Department of Psychology ( email )

University Park, PA
United States

Thomas Borkovec

Pennsylvania State University ( email )

University Park
State College, PA 16802
United States

Aaron Fisher

University of California, Berkeley ( email )

310 Barrows Hall
Berkeley, CA 94720
United States

James Boswell

University of Albany ( email )

1400 Washington Avenue
Building, Room 109
Albany, NY 12222
United States

Lauren Szkodny

Pennsylvania State University ( email )

University Park
State College, PA 16802
United States

Samuel Nordberg

Pennsylvania State University ( email )

University Park
State College, PA 16802
United States

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