New Strategies for Combining Mindfulness with Integrative Cognitive Behavioral Therapy for the Treatment of Generalized Anxiety Disorder
Open accessAbstract
Generalized anxiety disorder (GAD) severely impacts social functioning, distress levels, and utilization of medical care compared with that of other major psychiatric disorders. Neither pharmacological nor psychotherapy interventions have adequately controlled cardinal symptoms of GAD: pervasive excessive anxiety and uncontrollable worry. Research has established cognitive behavioral therapy (CBT) as the most effective psychotherapy for controlling GAD; however, outcomes remain at only 50% reduction, with high relapse rates. Mindfulness has been integrated with CBT to treat people suffering from numerous psychiatric disorders, with mindfulness based stress reduction (MBSR) being the most researched. Preliminary evidence supports MBSR's potential for controlling GAD symptoms and key researchers suggest mindfulness practices possess key elements for treating GAD. Classical mindfulness (CM) differs significantly from MBSR and possesses unique potentials for directly targeting process and state GAD symptoms inadequately treated by CBT. This article introduces the theory and practice of CM, its differences from MBSR, and a critical review of MBSR and CBT treatments for GAD. CM strategies designed to complement CBT targeting cardinal GAD symptoms are outlined with a case study illustrating its use.
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Focusing on the present moment experience may be another subtle form of control used to avoid engaging with worry.
“This last option is consistent with the suggestion that focusing on the present moment experience may be another subtle form of control used to avoid engaging with worry (Craske & Hazlett-Stevens, 2002; Rapgay et al., 2011).”
From The relationship between low levels of mindfulness skills and pathological worry: The mediating role of psychological inflexibility. [La relación entre habilidades de mindfulness y preocupación patológica: El rol mediador de la inflexibilidad psicológica] (2014) · cites this paper as Rapgay et al., 2011
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Cites
Mindfulness-based interventions in context: Past, present, and future
Kabat-Zinn, J. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bpg016 · Cited by 8,615 · cited 6× · see citing works
“They quote teachers like Chodron (2001) to describe how mindfulness can be used to feel the full force of an emotion as a way to overcome it. Marsha Linehan, Sona Dimidjian as well as Kabat-Zinn (2003) also imply that mindfulness practice involve affective related practices such as compassion.”
BackgroundMethodInfluentialMindfulness-based interventions in context: Past, present, and future.
Kabat-Zinn, J. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy/bpg016 · Cited by 8,612 · see citing works
(2008) · Medical Entomology and Zoology · Cited by 7,477 · see citing works
Mindfulness: A proposed operational definition.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., Segal, Z. V., Abbey, S., Speca, M., Velting, D., et al. (2004) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bph077 · Cited by 7,234 · see citing works
(1993) · Cited by 7,136 · see citing works
Cognitive-Behavioral Treatment of Borderline Personality Disorder
Cary, G. L. (1994) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1994.48.1.155 · Cited by 6,300 · see citing works
(1999) · Cited by 5,934 · see citing works
The Interpersonal Theory of Psychiatry
Sullivan, H. S., Perry, H. S., Gawel, M. L., & Cohen, M. D. M. B. (2013) · Routledge eBooks · doi:10.4324/9781315014029 · Cited by 5,268 · see citing works
Mindfulness training as a clinical intervention: a conceptual and empirical review
Baer, R. A. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bpg015 · Cited by 4,577 · cited 5× · see citing works
“They argue the therapeutic benefits of such an approach as an alternative to the habitual process and demands of working towards goals (Baer 2003).”
BackgroundInfluentialKabat-Zinn, J. (1982) · General Hospital Psychiatry · doi:10.1016/0163-8343(82)90026-3 · Cited by 4,255 · cited 1× · see citing works
“These approaches have included mindfulness based stress reduction (MBSR) (Kabat-Zinn 1982, 1990, 2003), mindfulness based cognitive therapy (MBCT) (Segal et al. 2002), dialectical behavior therapy (DBT) for borderline personality disorders (Linehan 1993a, b), and acceptance and commitment therapy…”
Method(2001) · Cited by 3,666 · see citing works
The effect of emotion on cue utilization and the organization of behavior
Easterbrook, J. A. (1959) · Psychological Review · doi:10.1037/h0047707 · Cited by 3,090 · cited 2× · see citing works
“These features of GAD include process symptoms such as uncontrollable, excessive and pervasive worrying, problems with disengaging from threatening stimuli, and state symptoms such as the narrow, and constricted states of attention characteristic of anxiety (Easterbrook 1959).”
BackgroundTHE INTERPERSONAL THEORY OF PSYCHIATRY
&NA; (1954) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-195407000-00064 · Cited by 2,918 · cited 1× · see citing works
“Psychoanalysts such as Horney (1950), Sullivan (1953) and Fromm-Reichmann (1955) presented an interpersonal perspective basis for anxiety.”
BackgroundEffectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders
(1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.7.936 · Cited by 1,941 · cited 13× · see citing works
“In the first study on the effects of MBSR on a variety of anxiety disorders including GAD, Kabat-Zinn et al. (1992) conducted an uncontrolled study with 22 patients.”
BackgroundInfluentialFreud, S., Ragg-Kirkby, H., & Bowie, M. (1938) · Medical Entomology and Zoology · Cited by 1,914 · see citing works
Psychiatric disorders in America
Robins, L. N. (1991) · Medical Entomology and Zoology · Cited by 1,567 · see citing works
Preliminary exploration of worry: Some characteristics and processes
Borkovec, T. D., Robinson, E., Pruzinsky, T., & DePree, J. A. (1983) · Behaviour Research and Therapy · doi:10.1016/0005-7967(83)90121-3 · Cited by 1,468 · cited 3× · see citing works
“Studies show that GAD patients rate interpersonal issues as the main source of their worry (Borkovec et al. 1983).”
BackgroundMiller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995) · General Hospital Psychiatry · doi:10.1016/0163-8343(95)00025-m · Cited by 1,131 · see citing works
Generalized anxiety disorder: advances in research and practice
(2005) · Choice Reviews Online · doi:10.5860/choice.42-3716 · Cited by 1,073 · see citing works
Generalized anxiety disorder: A preliminary test of a conceptual model
Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(97)00070-3 · Cited by 1,072 · cited 4× · see citing works
“Dugas et al. (1998) argue that treating the cause of uncontrollable worrying is more central to successful treatment of GAD, than focusing on the maintenance factors of worrying such as those described by Wells.”
BackgroundInfluentialAn object-relations theory of the personality
Fairbairn, W., & Jones, E. (1954) · Basic Books · Cited by 1,032 · see citing works
Meta-Cognition and worry: A cognitive model of generalized anxiety disorder
Wells, A. (1995) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465800015897 · Cited by 866 · cited 3× · see citing works
“Wells (1995) suggested the limits of CBT treatment outcomes for GAD results from only targeting the contents of worry, which he termed ‘‘type I worry’’, and failing to address meta-cognitive beliefs such as ‘‘worrying about worry’’ which he labeled ‘‘type II worries.’’”
BackgroundKabat-Zinn, J., Wheeler, E., Light, T., Skillings, A., Scharf, M. J., Cropley, T. G., Hosmer, D., & Bernhard, J. D. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199809000-00020 · Cited by 826 · cited 1× · see citing works
“A wide body of studies has shown the efficacy of MBSR for a wide range of medical and psychiatric conditions (Bishop et al. 2004; Kabat-Zinn et al. 1998).”
BackgroundBorkovec, T. D., Ray, W. J., & Stober, J. (1998) · Cognitive Therapy and Research · doi:10.1023/a:1018790003416 · Cited by 802 · cited 1× · see citing works
“They identified excessive, uncontrollable and pervasive worry as a critical symptom of GAD, and they modified the general CBT approach to primarily target this symptom (Borkovec et al. 1998).”
BackgroundHayes, A. M., & Feldman, G. (2004) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bph080 · Cited by 759 · cited 2× · see citing works
“Hayes and Feldman (2004) see mindfulness as an emotional balancing technique to help regulate mood, and increase clarity of affect.”
BackgroundBorkovec, T. D., & Costello, E. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.61.4.611 · Cited by 756 · see citing works
A cognitive model of selective processing in anxiety
Mathews, A., & Mackintosh, B. (1998) · Cognitive Therapy and Research · doi:10.1023/a:1018738019346 · Cited by 756 · cited 1× · see citing works
“The patient becomes overly sensitive to threat related cues and signals (Matthew and Mackintosh 1998).”
BackgroundKoster, E. H. W., Crombez, G., Verschuere, B., & De Houwer, J. (2004) · Behaviour Research and Therapy · doi:10.1016/j.brat.2003.08.001 · Cited by 709 · cited 2× · see citing works
“Research shows that vigilance and problems of disengaging from threatening stimuli is a mechanism of anxiety disorders (Koster et al. 2004).”
BackgroundMental illness in general health care : an international study
Üstün, T. B., & Sartorius, N. (1995) · Medical Entomology and Zoology · Cited by 610 · see citing works
Perils and promise in defining and measuring mindfulness: Observations from experience.
Brown, K. W., & Ryan, R. M. (2004) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bph078 · Cited by 585 · cited 5× · see citing works
“However, contrary to what Brown and Ryan (2004) suggested, classical mindfulness practice at its later phase reinstates meta-cognitive processes in order to encode experience acquired through the first phase of mindfulness.”
BackgroundInfluentialRoemer, L., & Orsillo, S. M. (2002) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.9.1.54 · Cited by 545 · cited 8× · see citing works
“Roemer and Orsillo (2002) combine acceptance and mindfulness integrated into a CBT protocol to target the primary cluster of symptoms of GAD i.e. experiential avoidance.”
BackgroundInfluentialCognitive therapy of anxiety disorders.
Chambless, D., & Gillis, M. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.61.2.248 · Cited by 522 · cited 2× · see citing works
“While CBT interventions show greater promise than other approaches, more studies are needed to confirm these preliminary findings (Chambless and Gillis 1993).”
BackgroundDavis, M. S. (2002) · The Concise Dictionary of Crime and Justice · doi:10.4135/9781452229300.n390 · Cited by 507 · see citing works
Ladouceur, R., Dugas, M. J., Freeston, M. H., Léger, E., Gagnon, F., & Thibodeau, N. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.6.957 · Cited by 446 · see citing works
Cognitive therapy of anxiety disorders.
Chambless, D. L., & Gillis, M. M. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.61.2.248 · Cited by 433 · see citing works
Mindfulness: A Proposed Common Factor
Martin, J. R. (1997) · Journal of Psychotherapy Integration publication discontinued · doi:10.1023/b:jopi.0000010885.18025.bc · Cited by 348 · cited 2× · see citing works
“Wells (2002) and Martin (1997) go further and suggest that awareness acquired through mindfulness helps patients detach from the habitual way of responding to negative and threatening stimuli.”
BackgroundDoes mindfulness meditation improve anxiety and mood symptoms? a review of the controlled research
Toneatto, T., & Nguyen, L. (2007) · The Canadian Journal of Psychiatry · doi:10.1177/070674370705200409 · Cited by 313 · cited 4× · see citing works
“However, inadequate evidence exists to date to demonstrate MBSR specifically accounts for reductions of GAD symptoms, since all such studies have lacked standard active control groups (Bishop et al. 2004; Toneatto and Nguyen 2007).”
BackgroundMethodInfluentialContrasting patterns of brain activity in anxious apprehension and anxious arousal
Nitschke, J. B., Heller, W., Palmieri, P. A., & Miller, G. A. (1999) · Psychophysiology · doi:10.1111/1469-8986.3650628 · Cited by 286 · cited 1× · see citing works
“A number of brain imaging studies confirm that excessive verbalization is a major factor in the maintenance of GAD (Jack et al. 1997).”
BackgroundSatipaṭṭhāna: The Direct Path to Realization
Anālayo (2004) · Medical Entomology and Zoology · Cited by 281 · see citing works
Does anxiety lead to selective processing of threat-related information?
Martin, M., Williams, R. M., & Clark, D. M. (1991) · Behaviour Research and Therapy · doi:10.1016/0005-7967(91)90043-3 · Cited by 277 · cited 1× · see citing works
“In fact, studies of selective attention to threatening information associated with various anxiety disorders, including GAD, demonstrate that the threat often operates outside awareness (Martin et al. 1991).”
BackgroundMetacognitive therapy for generalized anxiety disorder: An open trial
Wells, A., & King, P. (2006) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2005.07.002 · Cited by 254 · see citing works
Applied relaxation vs. cognitive therapy in the treatment of generalized anxiety disorder
Öst, L.-G., & Breitholtz, E. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00095-9 · Cited by 229 · see citing works
A new unified treatment approach for emotional disorders based on emotion science
Moses, E. B., & Barlow, D. H. (2006) · Current Directions in Psychological Science · doi:10.1111/j.0963-7214.2006.00425.x · Cited by 197 · cited 4× · see citing works
“2004), and the third involves an emotional processing based CBT (Moses and Barlow 2006).”
BackgroundInfluentialPsychodynamic Diagnostic Manual (PDM)
Stern, R. M. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09bk05461 · Cited by 162 · see citing works
Hayes, A. M. (2004) · Clinical Psychology Science and Practice · doi:10.1093/clipsy/bph080 · Cited by 152 · see citing works
GAD, Metacognition, and Mindfulness: An Information Processing Analysis
Wells, A. (2002) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy/9.1.95 · Cited by 150 · cited 3× · see citing works
“Others speculated that mental flexibility developed through this method and then applied to anxiety experiences can help to reduce patterns of cognitive rigidity associated with anxiety and worry by inhibiting secondary elaborative processing of thoughts and feelings (Wells 2002).”
BackgroundGAD, Metacognition, and Mindfulness: An Information Processing Analysis
Adrian Wells, A. (2002) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.9.1.95 · Cited by 149 · see citing works
Thoughts, images, worry, and anxiety
Freeston, M. H., Dugas, M. J., & Ladouceur, R. (1996) · Cognitive Therapy and Research · doi:10.1007/bf02229237 · Cited by 148 · cited 2× · see citing works
“For example, one of the main features of GAD is excessive self-verbalization and thinking that contributes towards the maintenance of uncontrollable and excessive worrying ( Freeston et al. 1996 ).”
BackgroundAcceptance, mindfulness, and science
Hayes, S. C. (2002) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy/9.1.101 · Cited by 140 · cited 2× · see citing works
“123 ( Hayes 2002; Bishop et al. 2004). Patients are simply instructed to adapt this state of openness without any specific training, and it therefore becomes a cognitive or self talk strategy in approaching anxiety.”
BackgroundOrsillo, S. M., Roemer, L., & Barlow, D. H. (2003) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(03)80034-2 · Cited by 113 · cited 3× · see citing works
“Orsillo et al. (2003), like many others, claimed that present moment experiencing associated with mindfulness helps to reduce anxiety about future oriented threatening events.”
BackgroundPerils and Promise in Defining and Measuring Mindfulness: Observations From Experience
Brown, K. W. (2004) · Clinical Psychology Science and Practice · doi:10.1093/clipsy/bph078 · Cited by 111 · see citing works
The Psychology of Awakening: Buddhism, Science, and Our Day-to-Day Lives
Watson, G., Batchelor, S., & Claxton, G. (2000) · Bristol Research (University of Bristol) · Cited by 94 · see citing works
Cognitive therapy for anxiety disorders.
Oakley, M. E., & Padesky, C. A. (1990) · PubMed · Cited by 90 · see citing works
Indra's net at work: The mainstreaming of Dharma practice in society.
Kabat‐Zinn, J. (2000) · Cited by 89 · see citing works
[Psychodynamic Diagnostic Manual, PDM].
Ferrari, H. A. (2007) · PubMed · Cited by 83 · see citing works
Miller, J., Fletcher, K., & Kabat‐Zinn, J. (1998) · International Journal of Yoga Therapy · doi:10.17761/ijyt.8.1.f5654n6515513127 · Cited by 81 · see citing works
Content Analysis of Worrisome Streams of Consciousness in Anxious and Dysphoric Participants
Molina, S., Borkovec, T. D., Peasley, C., & Person, D. C. (1998) · Cognitive Therapy and Research · doi:10.1023/a:1018772104808 · Cited by 68 · cited 2× · see citing works
“…Institute for Neuroscience and Human Behavior, P.O. Box 956968, Suite 2200, 300 Medical Plaza, Los Angeles, CA 90095-6968, USA e-mail: lrapgay@mednet.ucla.edu A. Bystritsky R. E. Dafter M. Spearman Department of Psychiatry and Bio-Behavioral Sciences, University of California, Los Angeles, CA, USA”
BackgroundResultGeneralized Anxiety Disorder Publications
Dugas, M. J. (2000) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(99)00034-1 · Cited by 56 · cited 1× · see citing works
“However, CBT strategies to reduce and regulate uncontrollable worrying proved to be limited, since anxious patients continued to find other reasons to worry (Dugas 2000).”
Background(2004) · Cited by 52 · see citing works
Facilitating symptom reduction and behavior change in GAD: The issue of control
Craske, M. G., & Hazlett-Stevens, H. (2002) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy/9.1.69 · Cited by 44 · cited 3× · see citing works
“Craske and Hazlett-Stevens (2002) also raised the point that acceptance could be another subtle form of control.”
BackgroundInfluentialThompson, C., Mazer, M., & Witenberg, E. G. (1955) · Modern Library eBooks · Cited by 25 · see citing works
Leahy, R. L. (2004) · Cited by 12 · see citing works
Flagged first, then by citations
Research works printed but not linked: 4
- Bhikkhu, T. (2002). The Agendas of Mindfulness. Access to Insight Edition 2002.
- Klein M Envy and gratitude and other words 1946–1963 1975 New York Delacorte Press/Seymour Lawrence
- Mennin DS Heimberg RG Turk CL Heimberg RG Turk CL Mennin DS Clinical presentation and diagnostic features Generalized anxiety disorder: Advances in research and practice 2004 New York The Guilford Press
- Newman MG Castonguay LG Borkovec TD Molnar C Heimberg RG Turk CL Mennin DS Integrative therapy for generalized anxiety disorder Generalized anxiety disorder: Advances in research and practice 2004 New York Guilford Press 320 350
Cited by
Sorted by citations
Prospects for a clinical science of mindfulness-based intervention
Dimidjian, S., & Segal, Z. V. (2015) · American Psychologist · doi:10.1037/a0039589 · Cited by 291 · see citing works
Sarris, J. J., Moylan, S., Camfield, D., Pase, M. P., Mischoulon, D., Berk, M., Jacka, F. N., & Schweitzer, I. (2012) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2012/809653 · Cited by 97 · see citing works
Pakenham, K. I. (2014) · Training and Education in Professional Psychology · doi:10.1037/tep0000074 · Cited by 31 · see citing works
Session-specific effects of the Metacognitive Training for Obsessive-Compulsive Disorder (MCT-OCD)
Miegel, F., Cludius, B., Hottenrott, B., Demiralay, C., Sure, A., & Jelinek, L. (2020) · Psychotherapy Research · doi:10.1080/10503307.2019.1613582 · Cited by 19 · see citing works
Ruiz, F. J. (2014) · Anales de Psicologia · doi:10.6018/analesps.30.3.150651 · Cited by 16 · see citing works
“Similarly, Craske and Hazlett-Stevens (2002) and Rapgay et al. (2011) suggested that focusing on the present moment experience may be another subtle form of control used to avoid engaging with worry.”
BackgroundPresencing process: embodiment and healing in the Buddhist practice of mindfulness of breathing
Virtbauer, G. (2016) · Mental Health Religion & Culture · doi:10.1080/13674676.2015.1115474 · Cited by 14 · see citing works
“, 2014), such as classical mindfulness, which (again as the name implies) is based on the Buddha’s teachings in the Pāli canon, this question has already clearly and practically successfully been answered with “no” (Rapgay & Bystrisky, 2009; Rapgay et al., 2011; cf. Williams & Kabat-Zinn, 2011).”
BackgroundPsychological Distress and Quality of Life in Patients with Laryngeal Cancer: A Review
Murariu, M. O., Boia, E. R., Sitaru, A. M., Mot, C. I., Negru, M. C., Brici, A. C., Zăhoi, D. E., & Balica, N. C. (2025) · Healthcare · doi:10.3390/healthcare13131552 · Cited by 11 · see citing works
“Studies have demonstrated that CBT can significantly reduce symptoms of depression and anxiety in head and neck cancer patients, including those with laryngeal cancer, with sustained effects over time [43].”
Existential perspectives and cognitive behavioral therapy
Praško, J. P., Mainerová, B., Jelenova, D., Kamarádová, D., & Sigmundova, Z. (2012) · Cited by 10 · see citing works
Servant, D., Germe, A., Autuori, M., de Almeida, F. D., Hay, M., Douilliez, C., & Vaiva, G. (2014) · L'Encephale · doi:10.1016/j.encep.2014.07.001 · Cited by 4 · see citing works
Department of Psychology, F. O. E. A. P., Ghaderi, F., Akrami, N., Department of Psychology, F. O. E. A. P., Namdari, K., Department of Psychology, F. O. E. A. P., Abedi, A., & Department of Psychology and Education of Children with Special Needs, F. O. E. A. P. (2022) · Iranian Journal of Psychiatry and Clinical Psychology · doi:10.32598/ijpcp.27.4.3067.3 · Cited by 7 · see citing works
Lo, J. W. K., & Ma, J. L. C. (2022) · Journal of Family Therapy · doi:10.1111/1467-6427.12398 · Cited by 7 · see citing works
Deo, S. K., Agrawal, K., & Bhattarai, P. (2018) · Nepalese Medical Journal · doi:10.3126/nmj.v1i2.21601 · Cited by 7 · see citing works
Rapgay, L., Ross, J. L., Petersen, O., Izquierdo, C., Harms, M., Hawa, S., Riehl, S., Gurganus, A., & Couper, G. E. (2013) · Mindfulness · doi:10.1007/s12671-013-0231-9 · Cited by 7 · see citing works
Self-citationOsborn, R., Girgis, M., Morse, S., Sladakovic, J., Kneebone, I., Shires, A., Durvasula, S., & Roberts, L. (2018) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-018-9602-4 · Cited by 5 · see citing works
Impostor Phenomenon on First- and Second-year College Students
Fahira, U. D., & Hayat, B. (2021) · Tazkiya Journal of Psychology · doi:10.15408/tazkiya.v9i2.19449 · Cited by 5 · see citing works
Popa, C. O., Rus, A. V., Skinner, C., & Jakab, Z. (2017) · Acta Marisiensis. Seria Medica · doi:10.1515/amma-2017-0035 · Cited by 5 · see citing works
Studi Kasus Gangguan Kecemasan Umum Warga Binaan Wanita di Lapas Jakarta
Malik, S., & Sovitriana, R. (2021) · Jurnal Ilmiah Psikologi MIND SET · doi:10.35814/mindset.v1i01.2643 · Cited by 4 · see citing works
ASSESSING THE ADOLESCENT EXPERIENCE OF MINDFULNESS
Lechtenberg, M. M. (2012) · K-State Research Exchange (Kansas State University) · Cited by 4 · see citing works
Treatment of Generalized Anxiety Disorders: Unmet Needs
Dılbaz, N., & Enez, A. (2013) · InTech eBooks · doi:10.5772/53453 · Cited by 3 · see citing works
Ghaderi, F., Akrami, N., Namdari, K., & Abedi, A. (2023) · Practice in Clinical Psychology · doi:10.32598/jpcp.11.2.862.1 · Cited by 2 · see citing works
TERAPIA RACIONAL EMOTIVA: UNA REVISION ACTUALIZADA DE LA INVESTIGACIÓN
Reyes, E. J. I., Pérez, G. O., & Flores, J. D. J. V. (2012) · Revista Electrónica de Psicología Iztacala · Cited by 2 · see citing works
Characteristics of Buddhist Psychology
Virtbauer, G. (2016) · Sigmund Freud PrivatUniversität Wien (SFU) · doi:10.15135/2014.2.1.1-9 · Cited by 2 · see citing works
McDonald, M. A., Berryhill, M. E., Lansing, A. H., & Lancaster, C. L. (2026) · Mindfulness · doi:10.1007/s12671-026-02774-1 · Cited by 1 · see citing works
Das Ungewisse besser tolerieren lernen – Interventionen bei geringer Ungewissheitstoleranz
Spitzer, N. (2019) · Psychotherapie: Praxis · doi:10.1007/978-3-662-58790-4_9 · Cited by 1 · see citing works
Spitzer, N. (2019) · Psychotherapie: Praxis · doi:10.1007/978-3-662-58790-4_5 · Cited by 1 · see citing works
Therapieziele bei geringer Ungewissheitstoleranz
Spitzer, N. (2019) · Psychotherapie: Praxis · doi:10.1007/978-3-662-58790-4_6 · Cited by 1 · see citing works
Hope, Mindfulness, and Anxiety in the Context of Racial Discrimination Among Black Young Adults
Murphy, E. R., Ge, J. L., & Gallagher, M. W. (2025) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-025-02655-8 · Cited by 1 · see citing works
Ungewissheitstoleranter werden: Selbsthilfe bei geringer Ungewissheitstoleranz
Spitzer, N. (2020) · Springer eBooks · doi:10.1007/978-3-662-61138-8_8
Die Dinge klarer kriegen: Selbsthilfe bei geringer Ungewissheitstoleranz
Spitzer, N. (2020) · Springer eBooks · doi:10.1007/978-3-662-61138-8_7
Treating Pediatric Generalized Anxiety Disorder with Mindfulness: A Case Series
Cheung, P., Curren, L. C., Coyne, L. W., Pincus, D. B., & Tompson, M. C. (2021) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2021.1908189
van Vreeswijk, M., Broersen, J., & Schurink, G. (2014) · Wiley eBooks · doi:10.1002/9781118753125.biblio
Ghaderi, F., Akrami, N., namdari, K., & Abedi, A. (2025) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_360_24
“…the results of some studies show that only 50% of people with GAD achieve positive results from treatment, [26] and 50% of people who undergo cognitive‑behavioral intervention at the end of treatment still have high symptoms and recurrence rates [18] and fail to achieve optimal treatment results.”
Zhina, Z. K. Y., ., Z. B., & Zanjani, Z. (2025) · Journal of Health Psychology · doi:10.1177/13591053251386385
“However, research shows that approximately 50% of individuals undergoing CBT continue to experience symptoms or suffer relapses post-treatment (Rapgay et al., 2011).”
From Scarce Resources to Resourcing Spirals: A Theory of Mindful Resourcing
Rubino, C., Perry, S. J., Kudesia, R. S., & Malka, A. A. (2026) · Organization Science · doi:10.1287/orsc.2022.17009
- Authors
- Rapgay, L., Bystritsky, A., Dafter, R. E., & Spearman, M.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Rapgay, Lobsang
- Venue
- Journal of Rational-Emotive & Cognitive-Behavior Therapy
- Published
- 2009-06-10
- Volume
- 29
- Issue
- 2
- Pages
- 92-119
- ISSN
- 0894-9085 (ISSN-L)
- 1573-6563
- PMC
- PMC3087104
- OpenAlex
- W2105918415
- Cited by
- 35
- References
- 58
- Citations by year
- 2026: 2 · 2025: 4 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 1 · 2014: 5 · 2013: 2 · 2012: 4
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of Rational-Emotive & Cognitive-Behavior Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- generalized anxiety disorder, mindfulness, mindfulness-based stress reduction, worry, treatment options, relapse
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