Abstract
BackgroundGeneralised anxiety disorder (GAD) is a chronic and debilitating condition characterised by high co-morbidity. Alongside pharmacological treatment, cognitive behavioural therapy (CBT) is an established psychological therapy for GAD. Its effectiveness is limited, however, with only an estimated 50% of clients presenting in the non-clinical range after a course of treatment. Furthermore, not all clients prefer CBT as a psychological therapy. Recently, emotion-focused therapy (EFT) was developed for GAD and was tested in an open trial with promising results.Methods/designThe present research project is a feasibility testing randomised controlled trial (RCT) that compares the efficacy of EFT with an established treatment for GAD, CBT. Sixty clients presenting in a primary care psychology/counselling service will be randomly assigned to one of two conditions: EFT or CBT. Outcomes will be assessed using several measures (Generalised Anxiety Disorder-7, Generalised Anxiety Disorder Severity Scale, Patient Health Questionnaire-9, and Clinical Outcome in Routine Evaluation – Outcome Measure). Clients will be assessed prior to and at the end of therapy, as well as at 6-month follow-up. On the basis of findings from the initial open EFT trial with regard to the optimal length of therapy, it is proposed that therapy last between 16 and 20 sessions.DiscussionThis study aims to test the feasibility of a full comparison RCT. It will test subject recruitment, therapist adherence to manualised treatment, and client retention rates. It will also provide estimates of comparative outcomes that can inform power calculations for a definitive trial.Trial registrationISRCTN Registry, ISRCTN52689081. Registered on 24 October 2017.
Highlights
Generalised anxiety disorder (GAD) is a chronic and debilitating condition characterised by high comorbidity
We propose that therapists continue to use the same criteria as currently used within Counselling in Primary Care (CIPC) when deciding whether to extend therapy; that is, (1) the client continues to be clinically distressed, and (2) the client expresses an explicit wish to continue with therapy for up to another 4 sessions
National Institute for Health and Care Excellence (NICE) recommends that GAD be treated with medication and/or psychological treatment, which is currently limited to various forms of cognitive behavioural therapy (CBT) [10]
Summary
Generalised anxiety disorder (GAD) is a chronic and debilitating condition characterised by high comorbidity. Cognitive behavioural therapy (CBT) is an established psychological therapy for GAD. Not all clients prefer CBT as a psychological therapy. Emotion-focused therapy (EFT) was developed for GAD and was tested in an open trial with promising results. Generalised anxiety disorder (GAD) is a common anxiety disorder [1]. Co-morbidity is high, with almost 60% of individuals diagnosed with GAD meeting diagnostic criteria for depression and an additional anxiety disorder [6]. Co-morbidity with personality disorders is very high, avoidant and dependent personality disorders [7]. People with GAD experience significant impairment in quality of life comparable to that of people with depression [8, 9]. GAD represents a significant cost to society owing to disability, decreased work productivity and increased use of health care services [5]
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