A patient shows up at the office of her primary care physician with symptoms such as restlessness, fatigue, inability to concentrate, irritability, muscle tension, and sleep disturbances. She complains that her worrying is interfering with her life. These are often key symptoms for a person suffering from Generalized Anxiety Disorder (GAD), a relatively common condition defined by chronic, pervasive worry.

To treat the condition, GAD sufferers may receive psychotropic drugs or cognitive behavioral therapies, which include psychoeducation, monitoring of anxiety levels, relaxation training, and cognitive techniques. However, these treatments aren’t always effective. Psychology professor Lizabeth Roemer and her colleagues, Drs. Susan Orsillo of the Boston VA Healthcare System and David Barlow, director of the Center for Anxiety and Related Disorders at Boston University, have been awarded a three-year, $375,000 National Institute of Mental Health grant to develop a new, more effective treatment for GAD.

Roemer and her colleagues are developing an acceptance-based treatment, which integrates cognitive behavioral therapies with mindfulness skills training. She believes that attempts to control or stop worrying are likely to be ineffective and actually may increase it. Currently, cognitive treatments for GAD focus on altering ways of viewing situations. Instead of encouraging GAD sufferers to try and change their feelings of anxiety, Roemer advocates teaching them how to accept these states of anxiousness while continuing to act in ways that are consistent with their desired goals.

“The therapy emerges from the cognitive behavioral tradition, but reframes the approach so it is not about emotional avoidance,” Roemer explains. “Attempts to control internal emotions may be unsuccessful. Instead, we can teach people to notice their anxiety, accept it, and not allow it to interfere with what they want to be doing in their lives,” she says.

Roemer and her colleagues will be working with clients at the Center for Anxiety and Related Disorders whose primary concern is GAD. The first phase of the project is to develop the treatment with twenty to thirty clients who volunteer to ,participate in the study. After researchers have fully developed the therapy, they will conduct a pilot study with approximately 30 participants. This research should lead to a larger, full-scale clinical trial.

At the clinic, they will work with clients to monitor their anxiety levels and teach them skills such as practicing mindfulness and relaxation tecniques, which encourage people to accept their emotions non-judgmentally without trying to avoid or supress them. The therapy also encourages their clients to use these skills and take “mindful action” in intended directions. For example, clients are encouraged to focus on acting in ways consistent with their life goals rather than simply reacting to anxiety and trying to avoid perceived threat.

How does this work? In therapy sessions, clients are asked to identify their values and to rank important elements in their lives. Therapists work collaboratively with the clients on a weekly basis asking them where they feel they are in relationship to these values and what could be interfering with their progress in these areas. “We want to help people regain a sense of choice in their lives by reducing the interference of anxiety,” says Roemer.

She gives an example of a client who ranks connecting with friends as an important value, but experiences anxiousness when attending parties. In the past, this client may have avoided parties because he wnated to avoid the feelings of anxiety. With the acceptance-based therapy he would have the skills to accept feelings of anxiety while consciously pursuing something that is important to him.

This work is part of Roemer’s larger body of research on understanding how individuals respond to unwanted emotional experiences in ways that better or worsen their difficulties. Recognized widley in her field, Roemer’s research on Generalized Anxiety Disorder will be highlighted with the work of co-author Orsillo in the upcomin issue of Clinical Psychology: Science and Practice. She has been at UMass Boston for five and a half years. She earned her B.A. in 1989 from Northwestern University and her Ph.D. from Pennsylvania State University, and completed her clinical internship in 1994-1995 at the Tufts University Medical School/Boston VA.

(This article appeared in The University Reporter)