Introduction & Theoretical Background
Excessive worry is the primary symptom of generalized anxiety disorder (GAD). Borkovec, Robinson, Pruzinsky and DePree (1983) gave an oft-cited definition:
“Worry is a chain of thought and images, negatively affect-laden and relatively uncontrollable. It represents an attempt to engage in mental problem-solving on an issue whose outcome is uncertain but contains the possibility of one or more negative outcomes. Consequently, worry relates closely to the fear process.”
In the initial stages of treatment for GAD it is helpful to orient clients to observing their worries as a process rather than focus on their content. It is important that clients understand the difference between real event worry (worry about actual events happening now) and hypothetical worry (worry about events that might happen in the future). It is also important that clients understand how worries can ‘chain’ together – they might start off worrying about an actual problem but end up worrying about