Cognitive Interventions for Anxiety 217
Step 7. Findings and Implications Summarized
A final step in empirical hypothesis testing is to summarize the findings and draw out
their implications for developing a new approach to anxiety. This summary statement
can be written on the Empirical Hypothesis- Testing Form and given to the client for
future reference. For Jodie the classroom experiment was summarized in the following
way:
“People often have exaggerated threatening thoughts like ‘everyone in the class is
looking at me and thinking there is something wrong with me.’ These thoughts
are often biased and even untrue yet they cause considerable anxiety. When we put
these thoughts to the test and realize they are not true, our level of anxiety will
decrease substantially. So in the future, when you feel anxious, ask yourself ‘Is my
thinking accurate or am I exaggerating the threat or danger in this situation?’ Test
it out against reality. If there is little evidence to support the thinking, come up with
an alternative view that you can act on.”Clinician Guideline 6.14
Empirical hypothesis testing is one of the most powerful clinical tools for changing anxious
thoughts, feelings, and behavior. Exercises are designed to test the accuracy of anxious inter-
pretations and reinforce the viability of alterative explanations. Effective behavioral experi-
ments require careful planning and specification that are derived from the cognitive case
formulation. Discussion of the outcome and its implications is an important component of
this therapeutic intervention.Cognitive strategies in Development:
expanDing the CliniCal armamentariumThe cognitive therapy approach to anxiety disorders is an evolving psychotherapy that
fosters new developments in therapeutic interventions that are derived from empirical
research and clinical experience. There are four new cognitive procedures that have
appeared in the clinical literature that may hold promise in the treatment of anxiety
disorders. Unlike the standard cognitive interventions discussed in the previous section,
these new interventions are still in the development phase and undergoing empirical
investigation. Until more is known about their efficacy and incremental contribution to
cognitive therapy, they should be utilized as auxiliary therapeutic strategies when con-
ducting cognitive therapy for anxiety.
Attentional Training Technique
Wells (2000) introduced the attentional training technique (ATT) as a therapeutic pro-
cedure for modifying the perseverative nature of self- referent processing. Highly per-
sistent, repetitive thought is often seen in the anxiety disorders in the form of worry,
obsessions, or anxious rumination. The rationale behind ATT is to teach the anxious