Peter M McEvoy1, David M Erceg-Hurn2, Rebecca A Anderson3, Bruce N C Campbell4, Amanda Swan4, Lisa M Saulsman4, Mark Summers4, Paula R Nathan2. 1. Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia. Electronic address: peter.mcevoy@curtin.edu.au. 2. Centre for Clinical Interventions, Perth, Australia; University of Western Australia, Perth, Australia. 3. Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia. 4. Centre for Clinical Interventions, Perth, Australia.
Abstract
BACKGROUND: Generalized anxiety disorder (GAD) is a common and highly comorbid anxiety disorder characterized by repetitive negative thinking (RNT). Treatment trials tend to exclude individuals with non-primary GAD, despite this being a common presentation in real world clinics. RNT is also associated with multiple emotional disorders, suggesting that it should be targeted regardless of the primary disorder. This study evaluated the acceptability and effectiveness of brief group metacognitive therapy (MCT) for primary or non-primary GAD within a community clinic. METHODS: Patients referred to a specialist community clinic attended six, two-hour weekly sessions plus a one-month follow-up (N=52). Measures of metacognitive beliefs, RNT, symptoms, positive and negative affect, and quality of life were completed at the first, last, and follow-up sessions. RESULTS: Attrition was low and large intent-to-treat effects were observed on most outcomes, particularly for negative metacognitive beliefs and RNT. Treatment gains increased further to follow-up. Benchmarking comparisons demonstrated that outcomes compared favorably to longer disorder-specific protocols for primary GAD. LIMITATIONS: No control group or independent assessment of protocol adherence. CONCLUSIONS: Brief metacognitive therapy is an acceptable and powerful treatment for patients with primary or non-primary GAD.
BACKGROUND: Generalized anxiety disorder (GAD) is a common and highly comorbid anxiety disorder characterized by repetitive negative thinking (RNT). Treatment trials tend to exclude individuals with non-primary GAD, despite this being a common presentation in real world clinics. RNT is also associated with multiple emotional disorders, suggesting that it should be targeted regardless of the primary disorder. This study evaluated the acceptability and effectiveness of brief group metacognitive therapy (MCT) for primary or non-primary GAD within a community clinic. METHODS:Patients referred to a specialist community clinic attended six, two-hour weekly sessions plus a one-month follow-up (N=52). Measures of metacognitive beliefs, RNT, symptoms, positive and negative affect, and quality of life were completed at the first, last, and follow-up sessions. RESULTS: Attrition was low and large intent-to-treat effects were observed on most outcomes, particularly for negative metacognitive beliefs and RNT. Treatment gains increased further to follow-up. Benchmarking comparisons demonstrated that outcomes compared favorably to longer disorder-specific protocols for primary GAD. LIMITATIONS: No control group or independent assessment of protocol adherence. CONCLUSIONS: Brief metacognitive therapy is an acceptable and powerful treatment for patients with primary or non-primary GAD.
Authors: Adrian Wells; David Reeves; Calvin Heal; Peter Fisher; Linda Davies; Anthony Heagerty; Patrick Doherty; Lora Capobianco Journal: Front Psychiatry Date: 2020-06-30 Impact factor: 4.157