GAD Psychological Rx — MRCPsych Paper B MCQ

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EasyAnxiety & Stress-Related DisordersGAD Psychological RxMRCPsych Paper B

An adult with generalised anxiety disorder has marked functional impairment and chooses an individual high-intensity psychological intervention rather than medication. According to NICE guidance, which treatment should be offered?

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Correct answer: A — Cognitive behavioural therapy or applied relaxation

The correct answer is **B: cognitive behavioural therapy or applied relaxation**. In the NICE stepped-care model, an adult with GAD and marked functional impairment, or an inadequate response to low-intensity interventions, may choose an individual high-intensity psychological intervention or medication. If psychological treatment is chosen, NICE recommends either CBT or applied relaxation, usually delivered over 12–15 weekly sessions. EMDR is principally used for trauma-related disorders such as PTSD, rather than as a recommended high-intensity treatment for GAD. Psychoanalytic psychotherapy, interpersonal psychotherapy and family therapy are not the NICE-recommended individual high-intensity interventions for GAD.

Reference: National Institute for Health and Care Excellence. Generalised anxiety disorder and panic disorder in adults: management (CG113), recommendations 1.2.17–1.2.20. Published 2011; updated 2024. https://www.nice.org.uk/guidance/cg113/chapter/Recommendations