Excessive worry is the primary symptom of generalized anxiety disorder (GAD). Borkovec, Robinson, Pruzinsky and DePree (1983) gave an oft-cited definition:
“Worry is a chain of thought and images, negatively affect-laden and relatively uncontrollable. It represents an attempt to engage in mental problem-solving on an issue whose outcome is uncertain but contains the possibility of one or more negative outcomes. Consequently, worry relates closely to the fear process.”
In the initial stages of treatment for GAD it is helpful to orient clients to observing their worries as a process rather than focus on their content. It is important that clients understand the difference between real event worry (worry about actual events happening now) and hypothetical worry (worry about events that might hap- pen in the future). It is also important that clients understand how worries can ‘chain’ together – they might start off worrying about an actual problem but end up worrying about hypothetical (any often low probability) scenarios. The Worry Diaryis a worksheet designed to assist clinicians and their clients in this task.
The Worry Diarycan be used in the initial stages of treatment for generalized anxiety disorder (GAD). It is a helpful way of orienting clients to observing their worries as a process rather than focusing on the content.
Clients can choose how to complete the diary:
- One option is to ask clients to record a selection of their worries over a period of at least a week. The aim is to collect a representative sample of the worries rather than a comprehensive account of every topic that was worried about.
- An alternative method is to take a sampling approach. Since people suffering from GAD are known to worry most of the time sampling a selection of worries at pre-specified times achieves the goal of creating an overview of the client’s worry.
- Borkovec, T.D., Robinson, E., Pruzinsky, T. & DePree, J.A. (1983) Preliminary exploration of worry: Some characteristics and processes. Behaviour Research and Therapy, 21, 9-16
- Dugas, M. J., Robichaud, M. (2007). Cognitive behavioral treatment for generalized anxiety disorder. Routledge.
- WIlkinson A., Meares, K., Freeston, M. (2011). CBT for worry & generalised anxiety disorder. Sage.