The group runs for 12 weekly 1¾ hour sessions with one or two weeks off to provide time to practice skills. The treatment method is cognitive behavioural therapy (CBT). Specifically it is based on a treatment protocol that research has shown is effective and is recommended by NICE (National Institute for Clinical Excellence) for use in the NHS. Part of the group is psycho-educational, though there will be some sharing of personal information, group discussion, and doing tasks together in the group. Together you will be working to change longstanding and ingrained patterns of mind or habits of thinking. A large part of therapy therefore is learning new skills. So, a central part of the therapy is performing tasks between sessions. You will need to be willing to commit to spending time performing these tasks during the week. You will also need to be able to commit to attending all the sessions.
The treatment covers a number of modules (some modules will be more relevant to you than others):
Worry awareness training:
This involves training yourself to become more aware of your worry, which will develop the skill of stepping out of it. We will be focussing more on the way in which your worry happens rather than the specific things you worry about. Rather than going into a lot of detail about all your of worries you will instead learn to distinguish between ‘real event worry’ – i.e. concerns that exist concretely now in the present for which you can do something about now, versus ‘hypothetical worry’ – i.e. concerns that may exist in the future but are not concrete issues that exist now, about which something can be done now.
Intolerance of uncertainty:
Many people with excessive worry find it hard to tolerate uncertainty, and this is believed to be a factor commonly underpinning worry. Often people only realise that they dislike uncertainty several weeks into the course. People use diverse strategies for reducing uncertainty, for example, avoiding risk taking, planning everything in advance, sticking excessively to routines; or perhaps it could be being excessively active so that you rarely have time to stop and allow uncertain things to occupy your mind. This module involves identifying and changing some of these habits – gradually exposing yourself to situations that generate uncertainty in order to gradually increase tolerance of uncertainty.
Positive beliefs about worry:
This involves identifying why we worry in the first place and testing and challenging these ideas. For example, some worriers believe that worry is useful and helps prevent things from going wrong.
Worriers tend to have good skills for problem solving, but tend not to be so good at applying these skills. Not solving problems well tends to increase the things there are to worry about. Some worriers procrastinate or spend too much time gathering too much information, whereas others may solve problems too quickly and impulsively. If required, you will learn to apply your problem solving skills more effectively – the way to deal with ‘real event worry’.
The process of worry tends to involve thinking around in circles while never getting to the actual heart of the matter. A small number of recurring deep themes tend to lie at the heart of people’s day to day worries. In the group you will come to identify these themes – the heart of your worry – and instead of avoiding thinking them about them in a deep way, you will be supported in doing so. This will help to defuse your worries.
This is an additional skill for dealing with worry. It’s a way of stepping away from worry in which you learn to become an observer of your troubling thoughts rather than actively engaged in them.