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CBT for GAD: Treating excessive worry by targeting the fear of uncertainty

Melisa Robichaud

20 Apr 2023

Introduction

Generalized Anxiety Disorder (GAD) can be a challenging disorder to diagnose and treat. From an assessment perspective, the primary feature of GAD (excessive and uncontrollable worry) is vague and subjective, and it is present in most other anxiety disorders. With respect to treatment, many interventions involve a range of strategies designed to specifically target client worries, however given the varied and shifting nature of worry content seen in GAD, these types of strategies can often feel like “chasing a moving target”. It can therefore be helpful to conceptualise GAD using theoretical formulations – and correspondent treatment protocols – that focus on the processes that underlie the excessive worry seen in GAD, rather than on the worries themselves. This workshop will focus on the process-driven understanding of GAD worry as a cognitive response to the perceived threat of uncertainty and its consequences on outcomes and personal coping due to an overall intolerance to uncertainty.


The event will be equivalent to 5.1/2hrs of CPD.

Content

This workshop will focus on clinical strategies designed to aid in the assessment, conceptualisation, and treatment of generalised anxiety disorder (GAD) through the lens of the construct of intolerance of uncertainty (IU). Specifically, the role of IU as the primary theme of threat in GAD will be introduced and applied both to a theoretical model of the disorder as well as an evidence-based CBT protocol for the treatment of GAD. Emphasis will be placed on introducing a cohesive rationale for treatment to clients that can logically account for their symptoms, as well as specific interventions to target the fear of uncertainty. Case vignettes, as well as detailed homework handouts and examples, will be included throughout.

Learning Objectives

Workshop participants will learn to:
• Assess and differentially diagnose generalised anxiety disorder
• Understand and conceptualise GAD symptoms within a CBT framework that highlights the role of intolerance of uncertainty
• Present a clinical model of GAD to clients that uses the fear of uncertainty as the primary theme of threat
• Identify GAD-specific safety behaviours
• Develop behavioural experiments designed to test out negative beliefs about uncertainty and its consequences
• Troubleshoot challenging presentations, including worries related to perfectionism, indecisiveness, and need for control

Training Modalities

Didactic content, case examples, Q&A

Key References

Beesdo-Baum, K., Jenjahn, E., Hofler, M., Lueken, U., Becker, E.S., & Hoyer, J. (2012). Avoidance, safety behavior, and reassurance seeking in generalized anxiety disorder. Depression and Anxiety, 29, 948-957.
Dugas, M.J., Sexton, K.A., Hebert, E.A., Bouchard, S., Gouin, J.-P., & Shafran, R. (2022). Behavioral experiments for intolerance of uncertainty: A randomized clinical trial for adults with generalized anxiety disorder. Behavior Therapy, 53, 1147-1160.
Robichaud, M., & Dugas, M.J. (2015). The generalized anxiety disorder workbook: A comprehensive CBT guide for coping with uncertainty, worry, and fear. New Harbinger: Oakland
Robichaud, M., Koerner, N., & Dugas, M.J. (2019). Cognitive-behavioral treatment for generalized anxiety disorder: From science to practice (2nd ed.). Routledge: New York.

About the presenter

Dr. Melisa Robichaud is a Founding Director of the Vancouver CBT Centre, where she works as a clinical psychologist specializing in the assessment and treatment of anxiety disorders. She is currently an adjunct faculty member in the University of British Columbia (UBC) Department of Psychology, a clinical instructor in the UBC Department of Psychiatry, and a clinical associate in the Simon Fraser University (SFU) Department of Psychology. She received her Ph.D. in clinical psychology at Concordia University in Montreal QC, completed her internship training at the UBC Hospital Anxiety Disorders Clinic, and a post-doctoral fellowship in the Department of Psychiatry at UBC Hospital.
Dr. Robichaud is a past President of the Canadian Association of Cognitive and Behavioural Therapies (CACBT) and has been certified as an expert in CBT by the organization. She is also on the Anxiety Canada Scientific Advisory Board, and served on their Board of Directors from 2006 to 2010. Her area of clinical specialization is CBT for anxiety disorders, with a special emphasis on generalised anxiety disorder. She has provided workshops internationally and has published numerous scientific articles and book chapters on the subject, as well as co-authoring several books on the cognitive-behavioural treatment of GAD.

Who should attend

This workshop is most suitable for CBT practitioners with some prior exposure to working with people with generalised anxiety disorder (GAD).

Low Intensity clinical contact hours survey - BABCP Low Intensity Special Interest Group

Please click below if you are interested in contributing to the survey.

 

The BACP Low Intensity SIG are interested in the impact of clinical contact hours on Low Intensity/Wellbeing Practitioner wellbeing. This questionnaire contains six multi-choice questions and a free text box for you to share your experiences. The answers to these questions will help the BABCP SIG plan how to meet CPD topics and other developments within the SIG.  The SIG hope to produce a write up of the answers to this questionnaire to be shared with SIG members and to be used in training.

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This FREE conference is for Psychological Wellbeing Practitioners working in Talking Therapies for Anxiety and Depression services and is brought to you by Bespoke Mental Health in collaboration with the NHS England Talking Therapies National PWP Leads Network

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