Volume 40, June 2025, 100817Author links open overlay panel, , , Highlights•

A construct-focused treatment protocol for GAD based around the intolerance of uncertainty model was tested within routine psychiatric care.

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Results showed high ratings on treatment satisfaction and treatment credibility.

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Patients had a good level of treatment engagement and low level of drop-out.

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Preliminary estimates of within-group effects show large reductions in self-rated GAD symptoms.

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Future research should verify effectiveness in a larger sample as well as investigate mechanisms of change.

Abstract

Generalized Anxiety Disorder (GAD) is a common and debilitating anxiety disorder with a chronic course and a low rate of spontaneous remission. Previous internet-delivered treatments for GAD in clinical routine care has been shown to be effective but tend to use a mix of many different treatment components, often based in several theoretical models. Another approach could be to instead develop more focused and theory driven treatments, potentially allowing the protocol to be shorter and less demanding for patients. In this pilot-feasibility-trial we implemented a treatment focusing on one target core construct (intolerance of uncertainty) at the internet psychiatry clinic in Stockholm. The treatment was administered to 22 individuals with GAD. We found a significant reduction in GAD symptoms of similar effect size to previous studies of CBT and ICBT for GAD in routine clinical care. Patients rated overall high levels of treatment satisfaction and treatment credibility. Only two patients dropped out from the treatment. Among the remaining patients a median of 7.5 out of 8 modules were completed. We conclude that the treatment protocol is preliminarily effective, acceptable to patients and clinicians, and feasible to implement in routine psychiatric care.

Keywords

Generalized anxiety disorder

Routine care

ICBT

CBT

Intolerance of uncertainty

Data availabilityIn order to comply with Swedish and EU laws regulating protection of identifiable individuals, data from this trial cannot be shared by the authors. R scripts used for data analyses can be found at https://osf.io/8cz5k/

© 2025 The Authors. Published by Elsevier B.V.