Generalized Anxiety Disorder: Major Approaches to Clinical Psychology

Introduction

The purpose of this essay is to explore major approaches to Generalized Anxiety Disorder (GAD). Generalized Anxiety Disorder will be explained and explored with regard to psychological approaches. Major psychological approaches will include psychodynamic, cognitive-behavioral, humanistic, and family systems. The essay will cover philosophical origins; the goals of each approach; techniques used by each approach; strategies used by each approach; how each approach affects the treatment strategies; and the effectiveness of each approach.

GAD is noted in patients through persistent, excessive, and unrealistic worry about everyday things. It is treatable and therefore can be managed (Barlow, 2001).

Philosophical Origins

Cognitive behavioral therapy (CBT): individuals with GAD engage over estimation and see dangers in any situation. They require several behavioral and cognitive interventions, which could be counterproductive and helpful in sustaining worry (Borkovec & Ruscio, 2001, p. 37).

Psychodynamic therapy: In psychodynamic approaches to GAD, the intervention generally concentrates on major conflicting issues. The aim is to develop a better therapeutic intervention that can restore emotional balance to eliminate insecure experiences.

Humanistic: Theorists argue that GAD emanates when individuals do not consider themselves in honest and accepting manner. People develop anxiety whenever they constantly reject their actual thoughts, objectives and emotions. This is the basis of Carl Rogers’s approach that the absence of “unconditional positive regard” during early stages of life leads to insensitive self-standards, known as “conditions of worth”.

The Family Systems Approach: The family systems approach attempts to utilize the family as a whole to treat problematic behavior and emotions. It aims to improve communication between family members, and bring attention to the whole family.

Identify the goals of each approach

Psychodynamic: In psychodynamic approaches to GAD, the intervention generally concentrates on major conflicting issues. Freud believed all children experience anxiety and use ego defense mechanism to help control it. The approach aims to concentrate on managing id rather than panic.

Cognitive-behavioral: highlights different mental, behavioral, and physiological aspects of GAD by relying on several strategies. The methods applied are cognitive skills that facilitate evidence-based thought processes, which diffuse some attention-oriented threats. Any shortcoming in problem solving is resolved by using other cognitive skills, which enhance coping, behavioral tendencies with a focus on decision-making and self-management. The behavioral strategies concentrate on tackling excessive concerns, delays and other behaviors associated with worrying.

Humanistic: practitioners of Rogers’s treatment approach, client-centered therapy, focus on the creation of an accepting environment where they can show positive regard and empathize with clients.

Family systems: manage the entire family and lessen dysfunctions affecting all family members, but more rigorously shown through a specific member of the family.

The techniques used by each approach

Psychodynamic: the technique strives to develop a better intervention approach to offer curative emotional experiences to lessen insecurity of the client. It applies similar normal methods used in managing all anomalies, which include free association and the therapist’s views on transference, resistance, and dreams.

Cognitive-behavioral: the techniques used aim to orient patients to adapt to certain mental and somatic adapting skills to control their nervousness as they are “repeatedly exposed to anxiety provoking images and activities” (Siev & Chambless, 2007, p. 513). The approach consists of patient teaching, self-management, repose skills, cognitive reorganization, imagery experiences, and exposure to anxiety inducing situations, and relapse prevention. Patients learn how to apply these techniques of cognitive reorganization to restore normal experiences with evidence-based and adapting appraisals rather than catastrophic experiences (Craske, 2013).

Humanistic: client-centered therapy, focus on the creation of an accepting environment where they can show positive regard and empathize with clients. This is the most effective technique applied by many therapists.

Family systems: many techniques are applied in the family systems approach such as reframing, paradoxical intention, joining, enmeshing, and disengagement. Reframing is changing how the patient perceives a behavior. Paradoxical intention is a technique where the patient normally acts out their problematic behaviors in order to feel more comfortable with treatment options.

Strategies used by each approach

Psychodynamic: Specific treatment for GAD involves Freudian strategies that concentrate more on managing id rather than fear. In addition, object-relations psychologists attempt to assist clients to recognize and resolve abnormalities in early stages.

Cognitive-behavioral: the strategy involves assisting clients to comprehend the critical aspects, associated with worrying and transforming their thoughts regarding it. Specifically, focusing on worry helps psychologists to educate clients regarding anxiety and GAD. It also involves self-management of bodily involuntary responses and cognitive reactions. During interventions, patients develop skills for recognizing their condition and its negative effects.

Humanistic: therapist listens intensely to the patient using reflection, summaries, and repetition. Empathy conveys to the patient that he or she is being heard as well as understood. Unconditional positive regard is the full acceptance of the thoughts and emotions of the patient.

Family systems: The general strategy strives to detach the client from abnormal family practices and restore normal relationships. The therapist may act as a member of the family to offer a common, neutral ground for developing mutual understanding and respect.

How each approach affects the treatment strategies?

Psychodynamic: the approach aims to detect insensible reactions, the psychologists must be able to understand and decode the clients thought processes, emotions, and dreams. The therapist also helps the client to recognize unconscious drives to assist in managing emotional conflicts.

Cognitive-behavioral: clients must learn to become self-reliant. The behavioral approaches are finally critical for the patient to continue with the controls of anxiety, and eventually lessen worries and concentrate on id. Clients must change their relationships with the environment and manage everyday events to avoid anxiety (Craske, 2009).

Humanistic: the client will be able to adapt in a suitable environment in which everyday worry shall not result into much anxiety because the client can only decide to alter his or her mental state under a favorable environments.

Family systems: the psychologist controls the family in evaluating their concerns and setting objectives through effective communication. The therapist must establish rapport with the entire family in order to assess possible worrying among members to identify dysfunctional cases. The family must assess its unit and acknowledge that the problem is beyond a single member.

The effectiveness of each approach

Psychodynamic: the approach is effective. Results from “a small clinical trial offer some evidence of efficacy for supportive-expressive therapy, a short-term psychodynamic therapy, in GAD” (Craske, 2013, p. 1). Supportive-expressive therapy had positive outcomes relative to other approaches for GAD.

Cognitive-behavioral: Clinical studies have established that this method is “more effective than psychodynamic therapy in GAD” (Craske, 2013, p. 1). Consequently, researchers have favored cognitive-behavioral approach over other approaches to manage the disorder. In fact, comparative studies have demonstrated that it works well relative to psychodynamic and a lack of treatment (Craske, 2013). In addition, cognitive-behavioral approach could be highly effective when supported with certain medications, such as either benzodiazepines or sertraline.

Humanistic: few empirical studies exist to clarify the efficacy of humanistic therapy in managing cases of Generalized Anxiety Disorder. Consequently, it is difficult to ascertain the effectiveness of the approach.

Family systems: the approach has been touted because of its focus on identifying specific issues that affect the family as a whole. However, not much evidence exists to support family systems therapy in managing cases of Generalized Anxiety Disorder in patients.

Conclusion

Generalized Anxiety Disorder is a serious chronic situation characterized by persistent, excessive, unrealistic worry about all aspects of daily life. Many philosophical approaches have been developed to management symptoms of the disorder. These approaches differ in terms of effectiveness, techniques and strategies. Nevertheless, they all aim to improve clients’ therapy outcomes and lessen the situation. Therefore, patients should only rely on effective methods to manage Generalized Anxiety Disorder.

Some studies have shown that cognitive-behavioral is superior to other approaches and could be highly effective when combined with certain medications. There is a need for further studies to develop empirical evidence to support many of these theories.

References

Barlow, D. H. (2001). Clinical Handbook of Psychological Disorders (3rd ed.). New York: Guilford Publications.

Borkovec, T., & Ruscio, M. (2001). Psychotherapy for generalized anxiety disorder. Journal of Clinical Psychiatry, 62 (Suppl 11), 37.

Craske, M. (2009). Cognitive behavior therapy. Washington, DC: American Psychological Association.

Craske, M. (2013). Psychotherapy for generalized anxiety disorder. Web.

Siev, J., & Chambless, L. (2007). Specificity of treatment effects: cognitive therapy and relaxation for generalized anxiety and panic disorders. Journal of Consulting and Clinical Psychology, 75(4), 513-22.

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