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Sudden Gains in Cognitive Behavioural Therapy and Metacognitive Therapy for Complex Anxiety Disorders
Kenneth M Pålerud1, Marieke A Helmich1, Asle Hoffart2
1Department of Psychology, University of Oslo, Oslo, Norway.
Clinical Psychology & Psychotherapy
|July 9, 2025
Summary
Sudden gains in anxiety symptom severity were observed in 19% of patients with complex anxiety disorders. Experiencing these rapid improvements, termed sudden gains, led to better long-term outcomes regardless of cognitive behavioural therapy or metacognitive therapy.
Area of Science:
- Psychiatry
- Clinical Psychology
- Behavioral Science
Background:
- Complex anxiety disorders are often long-lasting and treatment-resistant.
- Understanding factors contributing to rapid symptom improvement is crucial for optimizing treatment.
Purpose of the Study:
- To investigate the prevalence and characteristics of sudden gains in patients with complex anxiety disorders.
- To compare the occurrence of sudden gains between cognitive behavioural therapy (CBT) and metacognitive therapy (MCT).
Main Methods:
- A longitudinal study of 404 adults with anxiety disorders undergoing 8-week inpatient CBT or MCT.
- Symptom severity measured weekly using the Beck Anxiety Inventory (BAI).
- Sudden gains defined as ≥9-point, ≥25% difference, and stable BAI score improvements between sessions.
Main Results:
- Sudden gains occurred in 19% of the patient sample.
- Individuals with sudden gains showed significantly lower anxiety post-treatment and at 1-year follow-up.
- Sudden gains were present in both CBT and MCT, with similar prevalence, though MCT patients experienced them earlier.
Conclusions:
- Sudden gains are a relevant phenomenon in treatment-resistant anxiety disorders.
- These rapid improvements are associated with sustained positive treatment outcomes.
- Both CBT and MCT facilitate sudden gains, with potential timing differences between modalities.
Keywords:
anxiety disorderscognitive behaviour therapymetacognitive therapysudden gainstreatment outcomesMore Related Videos
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