418 TREATMENT OF SPECIFIC ANXIETY DISORDERS
Case Formulation
Cognitive therapy for GAD focuses on the faulty elaborative processing that contributes
to the persistence of anxious thinking and pathological worry (see Figure 10.1) as well
as the dysfunctional schemas responsible for the state of generalized anxiety. Thus the
cognitive case formulation centers on a clear specification of the idiosyncratic schemas
and faulty metacognitive processes of worry. Figure 10.2 illustrates the main compo-
nents of a cognitive case conceptualization for GAD.
figure 10.2. Cognitive case conceptualization of generalized anxiety disorder.
List worry-related current
concerns, goals, and
personal strivings
Specify internal
(intrusive) and external
worry triggers
LIST THE PRIMARY WORRY CONTENT AND
ASSOCIATED ANXIOUS SYMPTOMS
Describe the
metacognitive
appraisals profile
Specify the prominent
mental (worry) control
strategies
Determine presence of
negative problem
orientation and failed
safety search
MALADAPTIVE GAD
SCHEMAS OF THREAT, PERSONAL
VULNERABILITY, UNCERTAINTY, AND
METACOGNITION