The Contrast Avoidance Model (CAM) of Generalized Anxiety Disorder (GAD) was developed to conceptualize processes that motivate and maintain chronic worry (Llera & Newman, 2011). Having observed that many clients struggle to let go of their chronic worries (despite myriad negative consequences), Drs. Llera and Newman proposed a perceived positive function of sustained worry – to avoid emotional contrasts. According to the CAM, those with GAD fear the sudden surge in negative emotion that naturally follows a negative event. By sustaining worry, they embrace a prolonged negative emotional stance (preparedness), thus averting a sudden internal shift in the face of a negative event. Despite the temporary relief, such a strategy is purported to have devastating long-term consequences, including emotional, functional, and health-related impairment.
Given that worry is a transdiagnostic experience, the perspective of the CAM may apply across anxiety and mood disorders. The focus of this workshop will be on a) strategies for teaching clients about how CA & it's negative sequelae manifest in their lives and b) the use of procedures such as exposure techniques to help clients experience emotional shifts (contrasts) with less fear. Research about treatment recommendations for reducing CA will be covered.
Participants are encouraged to review the suggested readings in advance and to bring questions about situations in which functional impairment is maintained, at least in part, by CA processes. Together attendees will problem solve about implementing procedures to identify & address constructs described in the CAM to cases.
CE Learning Objectives
Following this presentation, participants will be able to:
1.) Describe the CAM of GAD and at least 2 of its implications for exposure therapy and behavioral experiments with clients meeting diagnostic criteria for GAD and related conditions.
2.) Describe one example of teaching clients about how CA & how it's negative sequelae manifest in their lives.
3.) Describe one example of how to use of exposure techniques to help clients experience emotional shifts (contrasts) with less fear.
Suggested Readings
Jamil, N. & Llera, S. J. (2021). A transdiagnostic application of the Contrast Avoidance Model: The effects of worry and rumination in a personal failure paradigm. Clinical Psychological Science, 9(5), 836-849. https://doi.org/10.1177/2167702621991797
LaFreniere, L. S., & Newman, M. G. (2023). Reducing contrast avoidance in GAD by savoring positive emotions: Outcome and mediation in a randomized controlled trial. Journal of Anxiety Disorders, 93, 102659. https://doi.org/10.1016/j.janxdis.2022.102659
Llera, S. J., & Newman, M. G. (2023). Contrast avoidance predicts and mediates the effect of trait worry on problem-solving impairment. Journal of Anxiety Disorders, 94, 102674. https://doi.org/10.1016/j.janxdis.2023.102674
Newman, M. G., & Llera, S. J. (2011). A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry. Clinical Psychology Review, 31(3), 371-382. doi: 10.1016/j.cpr.2011.01.008
About Dr. Llera
Dr. Sandra Llera is an Associate Professor of Psychology at Towson University, and the director of the Llera Laboratory for Emotion Regulation and Anxiety Research. She received her Ph.D. from the Pennsylvania State University in 2011 and joined Towson University in 2012. Dr. Llera’s dissertation focused on the emotional sequelae of chronic worry in generalized anxiety disorder (GAD). She completed her clinical internship at the University of Virginia counseling center. Dr. Llera’s current research focuses on exploring factors underlying the etiology and maintenance of anxiety and mood disorders, with an emphasis on understanding the role of emotional dysregulation in these processes.
Target Audience
This presentation is intended for licensed mental health professionals and advanced graduate student trainees seeking licensure and with some clinical experience. The instructional level of this presentation is INTERMEDIATE.
Continuing Education
- Philadelphia Behavior Therapy Association is approved by the American Psychological Association to sponsor continuing education for psychologists*. Philadelphia Behavior Therapy Association maintains responsibility for this program and its content.
- This program provides two (2) hours of CE credits.
- PBTA is also an authorized provider of CE credits for Professional Counselors, Marriage and Family Therapists, and Clinical Social Workers licensed in the state of Pennsylvania.
- ZOOM VIDEO LINK WILL BE SENT TO REGISTRANTS, WITHOUT OUTSTANDING BALANCE, 2 DAYS BEFORE & MORNING OF EVENT
- Full attendance with video display is required to obtain CE credit for this program. APA guidelines do not permit PBTA to issue partial CE credits. No refunds are provided for CE programs. No exceptions allowed.
- * PBTA does not currently offer CE to practitioners licensed in the state of New York.
- All events are Eastern Time Zone
- Contact PBTAcontinuingeducation@philabta.org if you need any learning accommodations no later than one week before event.
