Hope is a key factor in recovering from anxiety disorders

The concept of hope has long stirred opinion. In the sixteenth century, Martin Luther celebrated its power, claiming "Everything that is done in this world is done by hope." Two centuries later, Benjamin Franklin warned that "He that lives upon hope will die fasting." Into the conversation, Gallagher reports that psychotherapy can result in clear increases in hope and that changes in hope are associated with changes in anxiety symptoms.

More than pure philosophy, Gallagher has empirical evidence. His study examined the role of hope in predicting recovery in a clinical trial of 223 adults in cognitive behavior therapy (CBT) for one of four common anxiety disorders: social anxiety disorder, panic disorder, generalized anxiety disorder and obsessive-compulsive disorder.

"In reviewing recovery during CBT among the diverse clinical presentations, hope was a common element and a strong predictor of recovery," said Gallagher who reports that moderate-to-large increases in hope and changes in hope were consistent across the five separate CBT treatment protocols.

In terms of psychotherapy, hope represents the capacity of patients to identify strategies or pathways to achieve goals and the motivation to effectively pursue those pathways. Significantly, the results of this study indicate that hope gradually increases during the course of CBT, and increases in hope were greater for those in active treatment than for those in the waitlist comparison. The magnitude of these changes in hope were consistent across different CBT protocols and across the four anxiety disorders examined, which underscores the broad relevance of instilling hope as an important factor in promoting recovery during psychotherapy.

"Our results can lead to a better understanding of how people are recovering and it's something therapists can monitor. If a therapist is working with a client who isn't making progress, or is stuck in some way, hope might be an important mechanism to guide the patient forward toward recovery," said Gallagher.

Hope is closely related to other positive psychology constructs, such as self-efficacy and optimism, that have also been shown to have clear relevance to promoting resilience to and recovery from emotional disorders, said Gallagher.

Gallagher is the first author of the paper. The research is part of a larger project examining the efficacy of CBT for anxiety disorders led by David H. Barlow, founder and director emeritus of the Boston University Center for Anxiety and Related Disorders.