Emotion regulation therapy (ERT) is a type of therapy that has been successful in testing in adults with generalized anxiety disorder (GAD) and those with co-occurring GAD and major depressive disorder (MDD). ERT combines components of cognitive, acceptance, and mindfulness-based practices. Research shows reduced GAD and MDD symptoms by the end of treatment.

What is ERT

ERT is a present-focused, structured psychotherapy that emphasizes awareness of emotions, acknowledgement of conflict for safety and value-guided action, creation of a healthy distance from harsh thoughts and adoption of a more compassionate view of the self. Emotional awareness is developed through education about purpose of feelings. The use of meditation is aimed to help reduce emotional avoidance. Emotions are looked at as arising from within. From the ERT perspective, people with anxiety and low mood worry, ruminate, and look to others to help with unpleasant feelings. These people want to behave in line with personal values but feel it is too hard.

Differences from Traditional Therapy

Unlike CBT, the cognitive work of ERT does not focus explicitly on labeling cognitive distortions. While there is a shared aim of enhancing awareness of one’s thought patterns and their impact on behavior, ERT stresses development of positive self-talk.

ERT Sessions

In the initial phase of ERT, the goals are to gain emotional awareness and tolerance and to begin to catch yourself reacting in the moment. Mindfulness of emotions is practiced. Meditations are used in service to helping others to gain perspective on difficult moments, feelings, and beliefs. ERT integrates exposure and behavioral activation principles in and between sessions. Sessions may:

Include worry exposure
Use guided imagery
Use role play exercises where a person hears from and talks to their worried voice

ERT therapists may start sessions with an imagery exercise. Written homework is assigned and reviewed. The whole point is to ensure people have a way to expose worry and stress then work through the thoughts in a positive way.

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