Emotion-focused perspective on generalized anxiety disorder: A qualitative analysis of clients’ in-session presentations

Abstract

Objective: The classification of generalized anxiety disorder (GAD) is influenced by the tradition of conceptualizing disorders in the context of their clinical presentation and subsequent professional thinking around them. Our qualitative, descriptive-interpretative study uses a theoretical framework drawn from emotion-focused therapy (EFT) as the basis of our interpretation of GAD clients’ presentation of their difficulties. Method: The current research consists of an investigation into the GAD presentation based on a multiple case study observational qualitative design. In total, 93 video/audio-taped sessions from 14 clients were used for the analyses. The sessions were analyzed using an EFT case conceptualization framework. Results: The findings capture common themes across the cases covering the EFT framework domains: triggers of emotional pain (e.g., trauma, rejection), problematic self-treatment (e.g., worry, self-criticism, self-interruption), global distress (e.g., anxiety, low mood, somatic symptoms), apprehension/anxiety (fear of triggers and chronic painful emotions), emotional avoidance (e.g., self-distraction), behavioral avoidance (e.g., avoidance of conflict, over-compliance), core painful feelings (e.g., sadness/loneliness, shame, fear), and unmet needs (e.g., to be loved, to be acknowledged, to be protected). Conclusions: Discussion focuses on examining findings in the context of existing psychological models of GAD. The implications for practice as well as limitations of the study are also discussed.Clinical or methodological significance of this article: This is an attempt to provide an in-depth case conceptualization based on the EFT theoretical framework of the clients with GAD that attended EFT. Thus, it should contribute to clinical understanding of the presentation of the clients with GAD. Methodologically, the study uses an original qualitative approach, in which in-session presentations of 14 clients are thoroughly tracked and analyzed within an existing theoretical framework, the domains of which serve as the domains of inquiry.