Emotion Regulation Therapy


Emotion Regulation Therapy (ERT) is a manualized treatment that integrates components of cognitive-behavioral, acceptance, dialectical, mindfulness-based, and experiential, emotion-focused, treatments using a mechanistic framework drawn from basic and translational findings in affect science.

The goals of ERT are for individuals to become better able to:

  • Identify, differentiate, and describe their emotions, even in their most intense form;

  • Increase acceptance of affective experience and ability to adaptively manage emotions when necessary;

  • Decrease use of emotional avoidance strategies (such as worry, rumination and self criticism); and

  • Increase ability to utilize emotional information in identifying needs, making decisions, guiding thinking, motivating behavior, and managing interpersonal relationships and other contextual demands.


This mechanism-targeted behavioral intervention focuses on the training of three major emotion regulation skill groups: attention, allowance (targeted towards increasing implicit regulatory ability), distancing (decentering)(targeted towards more flexible responsivity to emotional stimuli; i.e., reactivity), and reframing (targeted towards greater utilization of explicit regulation).

These skills are taught in the first half of treatment and are then utilized by patients in an exposure/behavioral activation phase in the second half of treatment.

To date, the efficacy of ERT has been demonstrated in recently concluded NIMH-funded trials (NIMH R34 in collaboration with Dr. Richard Heimberg at Temple University) including an open trial and a randomized clinical trial. Patients in both trials evidenced reductions in measures of GAD severity, worry, trait anxious, and depression symptoms and corresponding improvements quality of life. These gains were maintained for nine months following the end of treatment. Evaluation of efficacy and investigation of treatment mechanisms is on-going in clinics at Kent State University and Hunter College.

Drs. Mennin and Fresco have been asked to speak about ERT or provide trainings in numerous academic, medical, and private settings nationally and internationally, and are currently writing a book on ERT for Guilford Press. Additionally, ERT is included in Dr. James Gross', Stanford University, Handbook of Emotion Regulation (Second Edition). Other writing and talks can be found in the publications and presentations pages of this website.