CBT for Generalized Anxiety Disorder (GAD)

Overview

GAD involves persistent, hard‑to‑control worry across multiple domains (health, work, relationships), often with restlessness, muscle tension, and sleep disruption. The worry process is reinforced by short‑term relief from reassurance and checking, which maintains long‑term anxiety.

Why CBT helps

• Intolerance of uncertainty: learning to approach uncertainty without over‑control reduces chronic worry.
• Worry awareness: distinguishing productive problem‑solving from unproductive mental rehearsal.
• Behavioral experiments: testing predictions to gather corrective evidence.

Core CBT strategies

• Scheduled worry periods: contain worry to a daily 15‑minute window.
• Uncertainty practice: choose small “let it be uncertain” reps (e.g., delay checking email).
• Problem‑solving steps: define the problem, list options, pick one next action, review outcome.

Journaling prompts

1. What is the feared outcome? What evidence supports it? What evidence suggests I can cope?
2. Is this worry actionable? If yes, what is one next step? If not, when is my next worry window?
3. Today’s uncertainty rep: what did I not control, and what happened?

Use the guided format in How to Journal.

When to seek care

If worry persists most days for months or causes significant impairment, a clinician can tailor CBT and discuss additional options as needed.