Worry postponement ("worry time") is often prescribed as an exploratory or standalone intervention relatively early in the treatment of GAD, but ‘worry postponement experiments’ can also be set up to test client beliefs regarding the uncontrollability of worry.
Patients with generalized anxiety disorder (GAD) spend significant amounts of time engaged in worry. Engagement in worry is reinforced by the beliefs that worry is uncontrollable, and that worry prevents the occurrence of negative events.
Worry postponement was first described in a study by Borkovec, Wilkinson, Folsenbee & Lerman (1983) where it was prescribed as a daily 30 minute ‘stimulus control’ task. The patient’s task was to notice that they were worrying and then deliberately choose to delay engaging in the worry until a later time. Compared to a no-treatment condition this intervention led to significant reductions the amount of reported daily worry.
Worry postponement has a range of beneficial effects including:
- Illustrating to clients that worries typically concern a limited number of themes
- Allowing clients to discover that postponed worries often feel irrelevant by the time they are revisited
- Helping to undermine client beliefs regarding the uncontrollability of worry
- Reducing client’s feelings of urgency regarding engaging with the worry content.
Worry postponement is often prescribed as an exploratory or standalone intervention relatively early in the treatment of GAD (e.g. Leahy, Holland & McGinn, 2012). Wells (2004) describes an alternative approach whereby ‘worry postponement experiments’ are set up to test client beliefs regarding the uncontrollability of worry. Using this method, the client is instructed to take regular belief ratings regarding the uncontrollability of worry across the course of the experiment.
InstructionsAs described above a ‘worry postponement’ task can be used with differing rationales. In the original Borkovec et al. (1983) study worry postponement was prescribed as a ‘treatment’ which should be practiced daily for 3 weeks, with participants led to expect that it would reduce their experience of worry. Some treatment plans advise the use of worry postponement relatively early in the treatment of GAD. Wells (2004) describes a contrasting use of worry postponement in the form of a behavioral experiment where it is used to test client beliefs in the uncontrollability of worry. The Worry Postponement worksheet gives an overview of the technique and can be used with either approach.
- Borkovec, T. D., Wilkinson, L., Folensbee, R., & Lerman, C. (1983). Stimulus control applications to the treatment of worry. Behaviour Research and Therapy, 21(3), 247-251.
- Leahy, R. L. Holland, S. J. F., McGinn, L. K. (2012). Treatment plans and interventions for depression and anxiety disorders(2nd edition). Guilford Press.
- Wells, A. (2004). A cognitive model of GAD: Metacognitions and pathological worry. In Heimberg, R. G., Turk, C. L., & Mennin, D. S. (Eds.), Generalized Anxiety Disorder: Advances in Research and Practice. Guilford Press.