Journal of Contemporary Psychotherapy

, Volume 37, Issue 2, pp 61–70 | Cite as

Systems-Centered Therapy: A Protocol for Treating Generalized Anxiety Disorder

  • Lawrence J. LaddenEmail author
  • Susan P. Gantt
  • Stephanie Rude
  • Yvonne M. Agazarian
Original Paper


The systems-centered short-term therapy protocol was adapted and applied in three single case studies with generalized anxiety disorder (GAD) patients in a ten-session individual treatment over a two week period. All three subjects showed substantial improvement and no longer met diagnostic criteria post-treatment. Changes were maintained at follow up both six months and one year later. These results are promising and suggest the importance of further research on SCT as a viable, alternative treatment for generalized anxiety disorder.


Systems-centered therapy SCT Generalized anxiety disorder Short-term therapy 


  1. Agazarian, Y. M. (1992). A systems approach to the group-as-a-whole. International Journal of Group Psychotherapy, 42(3), 177–203.PubMedGoogle Scholar
  2. Agazarian, Y. M. (1997). Systems-centered therapy for groups. New York: Guilford.Google Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. Washington, DC: Author.Google Scholar
  4. Arntz, A. (2003). Cognitive therapy versus applied relaxation as a treatment of generalized anxiety disorder. Behavior Research and Therapy, 41, 633–646.CrossRefGoogle Scholar
  5. Beck, A. T., & Steer, R. A. (1992). Beck anxiety inventory manual. San Antonio, TX: The Psychological Corporation/Harcourt Brace Jovanovich.Google Scholar
  6. Bieling, P. J., Antony, M. M., & Swinson, R. P. (1998). The state-trait anxiety inventory, trait version: Structure and content re-examined. Behaviour Research and Therapy, 36, 777–788.PubMedCrossRefGoogle Scholar
  7. Borkovec, T. D. & Newman, M. G. (1999). Worry and generalized anxiety disorder. Comprehensive Clinical Psychology, 6, 439–459.Google Scholar
  8. Borkovec, T. D., Newman, M. G., Pincus, A. L. & Lytle, R. (2002). A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems. Journal of Consulting and Clinical Psychology, 70(2), 288–298.PubMedCrossRefGoogle Scholar
  9. Borkovec, T. D., & Ruscio, A. (2001). Psychotherapy for generalized anxiety disorder. Journal of Clinical Psychiatry, 62, 37–45.PubMedGoogle Scholar
  10. Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716.PubMedCrossRefGoogle Scholar
  11. Davanloo, H. (1987). Clinical manifestations of superego pathology. International Journal of Short-Term Psychotherapy, 2, 225–254.Google Scholar
  12. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997). Structured clinical interview for DSM-IV Axis I Disorders: Clinician version: Administration booklet. Washington, D.C.: American Psychiatric Press.Google Scholar
  13. Fisher, P. L., & Durham, R. C. (1999). Recovery rates in generalized anxiety disorder following psychological therapy: An analysis of clinically significant change in the STAI-T across outcome studies since 1990. Psychological Medicine, 29, 1425–1434.PubMedCrossRefGoogle Scholar
  14. Forsyth, J. P., & McNeil, D. W. (2002). Mastery of your anxiety and worry: A multimodal study of the effectiveness of a manualized treatment for generalized anxiety disorder. Cognitive and Behavioral Practice, 9, 200–212.CrossRefGoogle Scholar
  15. Gantt, S. P., & Agazarian, Y. M. (2002). Systems-centered protocol for GAD.Google Scholar
  16. Kadera, S. W., Lambert, M. J., & Andrews, A. A. (1996). How much therapy is really enough: A session-by-session anlysis of the psychotherapy dose-effect relationhsip. Journal of Psychotherapy Research and Practice, 5, 132–151.Google Scholar
  17. Lambert, M. J., Lunnen, K., Umphress, V., Hansen, N. B. & Burlingame, G. M. (1996). Administration and scoring manual for the Outcome Questionnaire (OQ-45). Wilmington, DE: American Professional Credentialing Services LLC.Google Scholar
  18. Moras, K., Telfer, L. A., & Barlow, D. H. (1993). Efficacy and specific effects data on new treatments: A case study strategy with mixed anxiety-depression. Journal of Consulting and Clinical Psychology, 61, 412–420.PubMedCrossRefGoogle Scholar
  19. Segal, D. L., Hersen, M., & Van Hasselt, V. B. (1994). Reliability of the structured clinical interview for DSM-III-R: An evaluative review. Comprehensive Psychiatry, 35(4), 316–327.PubMedCrossRefGoogle Scholar
  20. Siegel, D. (1999). The developing mind. New York: Guilford.Google Scholar
  21. Skre, I., Onstad, S., Torgersen, S., & Kringlen, E. (1991). High interrater reliability for the structured clinical interview for DSM-III-R Axis I (SCID-I). Acta Psychiatrica Scandinavica, 84(2), 167–173.PubMedGoogle Scholar
  22. Spielberger, C. (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  23. Westen, D., & Morrison, K. (2001). A multidimensional meta-analysis of treatments for depression, panic and generalized anxiety disorder: An empirical examination of the status of empirically supported therapies. Journal of Consulting and Clinical Psychology, 69(6), 875–899.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Lawrence J. Ladden
    • 1
    Email author
  • Susan P. Gantt
    • 2
  • Stephanie Rude
    • 3
  • Yvonne M. Agazarian
    • 4
  1. 1.Systems-Centered Training and Research InstitutePhiladelphiaUSA
  2. 2.Emory University School of MedicineAtlantaUSA
  3. 3.University of Texas at AustinAustinUSA
  4. 4.Systems-Centered Training and Research InstitutePhiladelphiaUSA

Personalised recommendations