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Birmingham BABCP conference: pre-conference workshop on emotion regulation therapy with Doug Mennin & David Fresco (2nd post)

Yesterday morning I wrote about the BABCP pre-conference workshop that I was going to on "Emotion regulation therapy".  I cut & pasted information from the workshop publicity into the blog and many further details about this approach are available from their website "Emotion regulation therapy for chronic anxiety and recurring depression".

So how was the workshop?  Well, I'll give a narrow focus set of comments first, then I'll try to put this into the broader context of whether this new emotion regulation approach is likely to add to our helpfulness as therapists who struggle to relieve suffering more effectively.  So the narrow set of comments first ... well I think Doug & David did a bloody good job.  Wow, what a vast amount of work is involved over many years when one seriously tries to develop a more effective treatment approach.  They have gone about this persistently, thoughtfully, openly.  Great.  Huge congratulations to them.  

The early treatment outcomes are encouraging as well.  Quoting from their 2013 paper "Emotion regulation therapy for generalized anxiety disorder": "To date, the efficacy of ERT has been demonstrated in a recently concluded NIMH-funded open trial (OT; N = 19) and a randomized clinical trial (RCT; N = 60; Mennin & Fresco, 2011; Mennin, Fresco, Heimberg, & Ciesla, 2012) ... In terms of clinical outcomes, OT patients evidenced reductions in both clinician-assessed and self-report measures of GAD severity, worry, trait anxious, and depression symptoms and corresponding improvements in quality of life with within-subject effect sizes well exceeding conventions for large effects (Cohen’s d’s = 1.5 to 4.5). These gains were maintained for 9 months following the end of treatment. The RCT patients receiving immediate ERT, as compared to a modified attention control condition, evidenced significantly greater reductions in GAD severity, worry, trait anxious, and depression symptoms and corresponding improvements in functionality and quality of life with between-subject effect sizes in the medium to large range (d = .50 to 2.0). These gains were maintained for 9 months following the end of treatment ... not surprisingly given comorbidity rates (Kessler, Berglund, et al., 2005; Kessler, Chiu, Demler, & Walters, 2005), a sizable subgroup of GAD patients with comorbid MDD (N = 30) were enrolled and treated. Within-subject effect sizes in both clinician-assessed and self-report measures of GAD severity, worry, trait anxious, and depression symptoms and corresponding improvements in functionality and quality of life were comparable to the overall trial findings— thereby suggesting that MDD comorbidity did not interfere with treatment efficacy (Cohen’s ds = 1.5 to 4.0)."  OK.  So far, so good.  There's a long way to go before I would firmly support this approach as a significant step forward for treatment of challenging clients presenting with GAD and comorbid problems with depression.  The literature is kind of littered with painstakingly developed, fairly complex therapies attempting ... and failing ... to produce better results for GAD than simple well-taught applied relaxation. Fingers crossed for ERT.

 

General point ... see the major 2nd edition upgrade of this year's 668 page "Handbook of emotion regulation" edited by James Gross & involving contributions by over eighty other researchers.  

More to follow ... 

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