Online CBT Therapy & Group Therapy Sessions

The process of worry can be debilitating. It has been known that most people who suffer from Worry or GAD lead a poorer quality of life, and much of this has to do with their tendency to live ‘in the future’.  This can prevent living in the here and now, and having the ability to enjoy things without constantly thinking about what will happen next. Research has shown that people who experience GAD, tend to have thoughts that are in the form of “What if…?” Some examples of this can include: “What if my child drowns at his swimming lesson?” “What if I miss my deadline at work?” “What if I am late for my dentist appointment tomorrow?” According to Diagnostic and Statistic Manual of mental disorders (American Psychiatric Association; 1994), the characteristics and clinical presentation of GAD include excessive anxiety and worry for at least 6 months about a number of events, which are difficult to stop or control. Symptoms The main symptoms that accompany the anxiety and worry are fatigue, restlessness, difficulty concentrating, feeling irritable, experiencing muscle tension and sleep difficulties. These symptoms and feelings of anxiety and worry cause significant distress which impacts on social, occupational and other areas of functioning. Typically, we all have daily things that we worry about. GAD is about excessively worrying, where you find yourself building scenarios in your mind, taking everything that is uncertain in your life and trying to think of every possible eventuality to prevent surprises or to be prepared. Worry chains GAD sufferers may have ‘worry chains’, where one worry can lead to other worries with a negative outcome. Here is an example of a worry chain. ‘What if I miss my deadline at work? What if my boss fires me? I won’t find another job and I won’t be able to pay my bills…. How would I pay my mortgage? I will lose my house… then I'll be homeless.’

Here are some examples: You're given a big project to work on and think, “What if I miss my deadline for the project” – They will think I am incompetent – I will get sacked – I won’t be able to pay my mortgage – I will become homeless and destitute and my children will have to go into foster care. The impact of worry also comes in the form of fear and anxiety.  We can pick up positive and negative beliefs about worry, such as “If I worry, it shows I care” (positive), or “I can’t control my worrying, and I fear that it will be dangerous for my mental health” (negative).  We can also worry about worrying!  The result of this process leads to exhaustion and burnout. The cognitive approach that I use for GAD will look at four main features: intolerance of uncertainty, positive and negative beliefs of your worrying, negative problem orientation cognitive avoidance.

Group therapy is a form of intervention involving a small group (up to 6 people). It can help you feel less isolated, better understood and also gives you the opportunity to learn from others in the group who experience similar problems. Group Therapy can be taken on its own or blended in with individual sessions. It can also be cost effective to do group therapy instead of paying for individual sessions. The group programme that I deliver consists of 10 sessions and follows a 'metacognitive' approach which helps to break down the maintenance of GAD. The programme involves reducing avoidance, behaviour and thought changes to beliefs about worry, problem solving, intolerance of uncertainty, managing moods, relaxation and relapse prevention.

Diagnostic Summary for GAD/worry: Excessive anxiety and worry (apprehensive expectations), occurring more days than not for a period of at least six months, about a number of events and activities. The person finds it difficult to control the worry. The anxiety and worry are associated with three (or more) of the following six symptoms: Restlessness (or feeling keyed up or on edge) Being easily fatigued Difficulty concentration or mind going blank Irritability Muscle tension Disturbed sleep The anxiety, worry or physical symptoms cause clinically significant distress or impairment in social, occupation or other important areas of functioning. Adapted from APA, 2013. 

At your first appointment, a full and comprehensive assessment will be completed which will include your mental health history. It is important that we assess which problem is the most severe and what will improve overall functioning. It is common that GAD can coexist with other disorders, so it is important that the most severe problem is treated first. Following your assessment, we can discuss the best course of action to get you the relief you need.