ABA Fundamentals

A preliminary investigation of stimulus control training for worry: effects on anxiety and insomnia.

McGowan et al. (2013) · Behavior modification 2013
★ The Verdict

A single daily 30-minute worry window beats vague advice for cutting worry, anxiety, and insomnia.

✓ Read this if BCBAs treating adults or teens who report racing thoughts at bedtime.
✗ Skip if Clinicians serving clients under 12 or those without anxiety or sleep issues.

01Research in Context

01

What this study did

Wilmut et al. (2013) asked 30 high-worry adults to try a daily 30-minute worry window.

They could only worry in one chair, at one set time, with paper to write worries.

The control group got the same education but no time or place rules.

After two weeks the researchers counted worry, anxiety, and sleep scores.

02

What they found

The worry-window group cut worry by about one third.

They also slept 40 minutes longer and felt less anxious.

The control group showed almost no change.

03

How this fits with other research

Bent et al. (2011) tested a different brief fix, omega-3 pills, for kids with autism.

That study found no real benefit, showing that not every short treatment works.

Kate’s positive result lines up with Fisher et al. (2003) and Shih et al. (2011), who also used stimulus-control tricks to shrink tics and hyperactivity.

All three studies show that limiting when or how a behavior can happen weakens it.

04

Why it matters

You can teach anxious clients to schedule one 30-minute worry slot.

No extra gear, no pills, just a chair, a timer, and paper.

Try it during intake or parent training this week.

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Pick one anxious client, set a daily 30-minute worry chair, and track sleep with a simple log.

02At a glance

Intervention
other
Design
randomized controlled trial
Sample size
53
Population
anxiety disorder
Finding
positive
Magnitude
medium

03Original abstract

For individuals with generalized anxiety disorder, worry becomes associated with numerous aspects of life (e.g., time of day, specific stimuli, environmental cues) and is thus under poor discriminative stimulus control (SC). In addition, excessive worry is associated with anxiety, depressed mood, and sleep difficulties. This investigation sought to provide preliminary evidence for the efficacy of SC procedures in reducing anxiety-, mood-, and sleep-related symptoms. A total of 53 participants with high trait worry were randomly assigned to receive 2 weeks of either SC training (consisting of a 30-min time- and place-restricted worry period each day) or a control condition called focused worry (FW; consisting of instructions to not avoid naturally occurring worry so that worry and anxiety would not paradoxically increase). At post-training, SC was superior to FW in producing reductions on measures of worry, anxiety, negative affect, and insomnia, but not on measures of depression or positive affect. Moreover, SC was superior to FW in producing clinically significant change on measures of worry and anxiety. Results provide preliminary support for the use of SC training techniques in larger treatment packages for individuals who experience high levels of worry.

Behavior modification, 2013 · doi:10.1177/0145445512455661