Biopsychosocial therapy of generalized anxiety disorder. Integrative treatment concept

Egle, Ulrich T; Bättig, Isabelle; Neufeld, Joel; Ballweg, Tobias; Cattapan, Katja (2022). Biopsychosocial therapy of generalized anxiety disorder. Integrative treatment concept. Psychotherapeut, 67(3), pp. 240-247. Springer-Medizin-Verlag 10.1007/s00278-021-00567-6

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The corona pandemic has led many people to experience an existential threat and has triggered different forms of coping with this persistent stress situation. The risk for the development of a generalized anxiety disorder (GAD) in particular has significantly increased. The established concepts of cognitive behavioral therapy (CBT) are only moderately effective in the treatment of GAD. Therefore, an integrative therapy concept is developed with reference to the biopsychosocial approach. This mediates a reference to early influences in the primary family (insecure ambivalent attachment, suppression of curiosity behavior) even during the psychoeducation as the cause of a permanent worrying and the underlying intolerance of uncertainty. The initial priority is on establishing a sustainable therapeutic relationship (alliance) in which the patient’s autonomy and self-efficacy are promoted. Of central importance to therapeutic progress is the promotion of experiences that enhance self-efficacy and the reduction of avoidance behavior through exposure and behavioral experiments. The reduction of maladaptive anxiety coping through worry chains and reassurance behavior occurs through the development of an increasingly greater tolerance of uncertainty in actual daily life. Essential for the prognosis are the consideration of metacognitions and dysfunctional relationship patterns in the couple relationship as well as carrying out relaxation procedures and correctly dosed exercises. Finally, it is a matter of the processing of dysfunctional coping strategies, which promote chronification.

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