درمان تنظیم احساسات برای اختلال اضطراب فراگیر

Despite the success of cognitive behavioral therapies (CBT) for emotional disorders, a sizable subgroup of patients with complex clinical presentations, such as patients with generalized anxiety disorder, fails to evidence adequate treatment response. Emotion Regulation Therapy (ERT) integrates facets of traditional and contemporary CBTs, mindfulness, and emotion-focused interventions within a framework that reflects basic and translational findings in affect science. Specifically, ERT is a mechanism-targeted intervention focusing on patterns of motivational dysfunction while cultivating emotion regulation skills. Open and randomized controlled psychotherapy trials have demonstrated considerable preliminary evidence for the utility of this approach as well as for the underlying proposed mechanisms. This article provides an illustration of ERT through the case of “William.” In particular, this article includes a case-conceptualization of William from an ERT perspective while describing the flow and progression of the ERT treatment approach.

Individuals with generalized anxiety disorder (GAD) frequently live by the maxim that “most miseries lie in anticipation” (Balzac, 1897). Their lives are marked by strong emotional experiences often discussed as emotionality, intensity, or distress and that are particularly characterized by a cautiousness that favors protection over promotion (Chorpita et al., 1998, Klenk et al., 2011 and Woody and Rachman, 1994); they are often self-conscious about the interpersonal relationships and the events in their lives (Przeworski et al., 2011), and they tend to worry and perseverate as a way to manage this emotional distress (Borkovec, Alcaine, & Behar, 2004). Emotion Regulation Therapy (ERT; Mennin & Fresco, 2009) represents our effort to better understand and reduce the suffering caused by GAD, particularly when it is accompanied by co-occurring depression. The ERT model melds principles from traditional and contemporary cognitive behavioral treatments (e.g., skills training and exposure) with basic and translational findings from affect science to identify targets of treatment in terms of core disruptions of normative cognitive, emotional, and motivational systems. Contrasting a client’s difficulties with what we understand as normative functioning allows us to generate theory-driven hypotheses that form the basis of our case conceptualization and treatment planning (e.g., Sanislow et al., 2010).