Research has shown the most common way to treat a generalized anxiety disorder, or GAD, is through therapy. The most common form of therapy used on these types of patients is cognitive behavioral therapy, or better known as CBT therapy. This form of therapy is where the therapist and the patient agree the patient has negative thoughts or behaviors they need to work on. The therapist is focused on the problem and asks and gives advice along with techniques to help the patient better treat the problem themselves. The resolution of ambivalence is the central purpose. This form of therapy often helps establish a trust among the patient and therapist. However, it has been shown to be ineffective or lose its effectiveness over time. A patient may be willing to listen or try to listen to the therapists suggestions or advice to deal with their problem, however, there is often very little behavior or thought change according to the results of a five-year, randomized clinical trial of a new combined treatment approach led by Henry Westra and Michael Constantino at the University of Massachusetts Amherst and Martin Antony at Ryerson University, Toronto.
Constantino noticed a remarkable increase in effectiveness of therapy when using CBT combined with motivational interviewing, or MI therapy. MI therapy is goal driven where the therapist keeps in mind the outcome they would like to see in the patient but uses a method of asking calculated questions that will help the patient realize this themselves. This technique is believed to be more effective because the patient is already listening to their own ideas and it is very hard to accept someone else’s ideas as their own. However since they realize the benefits of change on their own, they believe it to be their own organic idea and are more willing to act on their new goal or outcome of therapy. This form of therapy is also great in reducing the clash that typically happens between patient and therapist resulting in the likelihood of the patient to stay in therapy for the time required to notice an effective change.
To obtain evidence of this new change in therapy, researchers recruited 85 participants in Toronto and randomly assigned 43 of them to receive CBT alone. Likewise, they also randomly assigned 42 to receive CBT plus MI. Patients attended 15 therapy sessions.
The results of the study, at first, showed no significant differences between the two groups. However, after one year, the group that received CBT and MI were doing substantially better than the group who received CBT alone. Many had changed their behaviors and thoughts almost completely and were still taking the advice of the therapist while still being focused on their “own” calculated goal that was created in therapy specifically for them. It is still not known why the combined treatment displayed a “sleeper effect” and showed no improved signs until one year later. However, studies are being done now to make this more clear.
Regardless, the new information that was gained is extremely beneficial knowing that therapy can always be improved. The findings of this study will hopefully be used to train the next generation of therapists and create better treatment in the future for anxiety sufferers everywhere.
Sources: Integrating Motivational Interviewing With Cognitive-Behavioral Therapy for Severe Generalized Anxiety Disorder: An Allegiance-Controlled Randomized Clinical Trial. Westra, Henny A.; Constantino, Michael J.; Antony, Martin M. Journal of Consulting and Clinical Psychology, Mar 17, 2016, No Pagination Specified.