Generalized Anxiety Disorder (GAD) is typically considered a chronic condition characterized by excessive worry. Lifetime prevalence is 4.3-5.9%, yet only a small percentage seeks treatment. GAD is treatable and in recent years internet-delivered treatment interventions have shown promise. This paper aims to systematically search for literature on internet-delivered psychological interventions for the treatment of GAD and conduct a meta-analysis to examine their efficacy. The purpose of the paper is to inform the community of researchers, program developers and practitioners in internet delivered interventions of the current state-of-the-art and research gaps that require attention. A systematic search of the literature was conducted to find all studies of internet-delivered treatments for GAD (N = 20). Using Review Manager 5 all Randomized Controlled Trials (RCTs; n = 11) that met our established eligibility criteria were included into a meta-analysis that calculated effect sizes via the standardized mean difference. Compared to the waiting-list controls, the results demonstrate positive outcomes for GAD symptoms (d = −0.91) and its central construct of pathological worry (d = −0.74). The meta-analysis supports the efficacy of internet-delivered treatments for GAD including the use of disorder-specific (4 studies) and transdiagnostic treatment protocols (7 studies). Caution is advised regarding the results as the data is limited and highly heterogeneous, but revealing of what future research might be needed.

Aim: The qualitative experience of clients judged by quantitative measures as having 'good' or 'poor' outcome is not often the focus of outcome research. This exploratory study investigates client experience of psychological therapy in an inner-city primary care centre across two client groups, differentiated on the basis of their outcome scores on quantitative measures. Method: Clients (N011) were allocated to one of two research groups, (a) good outcome (n 05), or (b) poor outcome (n 06) on the basis of their pre-and post-therapy outcome scores on the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). They participated in a face-to-face semi-structured interview. Data were recorded and analysed using a descriptive and interpretive qualitative method. Results: Both groups had broadly similar experiences of their current therapy although some differences in emphasis emerged. Good outcome clients described a greater sense of empowerment in therapy, commenting on a feeling of equality with their therapist and exhibiting greater autonomy overall. Poor outcome clients valued therapist support and while reporting increased awareness of problematic functioning described a reluctance to engage fully in the therapeutic process. Conclusion: There was very little difference in the qualitative accounts of therapy and its impact by the clients deemed by quantitative pre-post therapy measurement as either 'good outcome' or 'poor outcome'. There is further research warranted, examining whether clients that seem to benefit from therapy according to standard pre-post measurement, experience therapy and its impact differently to clients whose pre-post results suggest that therapy did not work.

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Among psychological therapies for generalized anxiety disorder (GAD), cognitive-behavioral therapy has a dominant position as the most studied therapy. However, some researchers have recommended that to increase treatment options and broaden choice for clients, non-cognitive-behavioral therapy models for GAD should be examined. The present study was an exploratory study, assessing pre-post outcomes and 6-month follow-up of emotion-focused therapy for GAD, supplemented by qualitative posttherapy client accounts of helpful and unhelpful aspects of therapy and changes reported since therapy started. Fourteen clients were assessed on several measures focusing on GAD symptoms, depressive symptoms, and general psychological functioning. Quantitative pre-post and 6-month follow-up data indicated large effect sizes. Qualitative data captured changes in emotional functioning, anxiety, self-acceptance, self-confidence, and self-understanding. Clients reported as helpful both relational aspects of the work and in-depth experiential tasks, although some found the experiential aspect of the work difficult. The findings suggest that there may be value in assessing emotion-focused therapy as a treatment for GAD in a randomized controlled trial. (PsycINFO Database Record

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