Group Therapy Using the "I-Reconstruction" Psychotherapy Method to Reduce Anxiety Levels

RESEARCH PROTOCOL (CONSORT) Title Group Therapy using the I-Reconstruction Psychotherapy Method for Anxiety Reduction: A Randomized Controlled Trial.

• Rationale Anxiety disorders remain one of the most widespread forms of mental pathology, significantly reducing the quality of life and social functioning of millions of people worldwide. Despite the recognized efficacy of Cognitive Behavioral Therapy (CBT) and pharmacological treatment as empirically supported approaches, a significant percentage of patients do not achieve full remission, and the treatment gap remains critically large. This underscores the necessity for finding and empirically testing new, deep-rooted psychotherapeutic interventions. This is where the I-Reconstruction psychotherapy method becomes relevant.

The I-Reconstruction method is a new but promising approach that offers a unique perspective on personality structure and the genesis of anxiety disorders. Central to the method are desire, possession, and satisfaction, which are viewed not merely as mental states but as fundamental structural elements of the personality that shape its interaction with the world. Dysfunctions or conflicts within these elements-specifically, impaired capacity to possess one's own emotional and life resources or the frustration of desire-directly lead to the formation of anxiety.

From the perspective of modern psychology, the inability to achieve satisfaction or unfulfilled desire are often catalysts for anxiety and pathological fixation. Researchers emphasize that impairments in self-regulation processes, including the capacity for adequate desire and the attainment of satisfaction, are closely linked to the development of a wide range of mental disorders, including anxiety. Specifically, issues with self-esteem and the possession of internal states often manifest as generalized anxiety and avoidance, highlighting the need for psychotherapeutic intervention aimed at these deeper structures. While CBT focuses on cognitive and behavioral patterns, I-Reconstruction aims for deeper change by restoring the integration of desire and possession as a healthy foundation for obtaining satisfaction, which is theoretically expected to yield a more stable reduction in anxiety levels.

Contemporary empirical studies confirm the link between this triad and the emergence of anxious symptoms. For instance, within Self-Determination Theory, the frustration of basic needs for autonomy and competence-i.e., the disruption of the sense of agency and possession over one's own actions-correlates with heightened anxiety and reduced psychological well-being. This mechanism demonstrates that the lack of experience in "possessing" one's own desires or internal states can intensify feelings of helplessness and loss of control-core characteristics of anxiety.

Secondly, neuro- and psychophysiological studies indicate that reward system dysfunctions-reduced anticipation of reward and difficulties in experiencing pleasure (anhedonia)-are found not only in depression but are also associated with anxious manifestations. Research on reward processing shows that reduced reward sensitivity and changes in neural correlates of reward are linked to persistent tension, hypervigilance, and altered decision-making strategies that maintain anxious states.

Thus, when desire remains frustrated, the sense of possession over one's experience is weakened, and the ability to experience satisfaction is impaired, a "triad of frustration" is formed that can sustain anxiety at cognitive, emotional, and bodily levels. This picture provides an empirical basis for applying the I-Reconstruction method, which aims to restore agency (possession), actualize conscious desires, and restore the capacity to experience satisfaction in order to stabilize anxious symptoms.

• Design This study is a randomized controlled trial (RCT) with three parallel groups (2 experimental and 1 control). The duration of participation for each participant is approximately 17 months. This period includes a screening and initial assessment phase (T1), a course of therapy sessions (T2-T3), and a series of delayed measurements at 3, 6, and 12 months after the intervention (T4-T6).

2.1. Recruitment and selection process of participants Recruitment will be used online through the official pages of the NGO "International Association of Psychosomatics and Health Therapy" on social networks (Facebook, Instagram) and on the Association's website. An information announcement will be published with a description of the study, participation criteria and links to the screening survey.

Potential participants who express interest will be directed to an online questionnaire (implemented on the Google Forms platform), where they will fill in:

• Demographic data.
• Screening tools: Beck Anxiety Inventory (BAI), HADS-A anxiety subscale, Diagnosis of Preverbal Dysregulation (DPD) questionnaire and Internal Conflict Test (ICT) to check inclusion/exclusion crit

Inclusion criteria

Age between 18 and 55 years (inclusive).

Clinically significant level of anxiety according to the Beck Anxiety Inventory (BAI) ≥ 9 points.

Anxiety subscale score on the Hospital Anxiety and Depression Scale (HADS-A) ≥ 11 points.

Significant level of preverbal trauma according to the "Diagnostics of Preverbal Dysregulation" (DPD, T. Pavlenko) questionnaire: total score ≥ 16.

Specific subscale scores in DPD: "Desire" ≥ 5, "Satisfaction" ≥ 5, and "Possession" (Obsession) ≥ 6 points.

Presence of internal conflicts according to the "Internal Conflict Test" (ICT) ≥ 1 point on the skin tissue measurement scale.

Willingness to comply with the study protocol and the online therapy format.

Exclusion criteria

Current participation in any other psychotherapy during the study.

Use of any psychotropic medications within the last 30 days (antidepressants, tranquilizers, neuroleptics, mood stabilizers).

Diagnosed severe mental disorders (according to ICD-10/DSM-5) requiring specialized psychiatric care or inpatient treatment.

Presence of acute suicidal risk.

Substance abuse (alcoholism, drug addiction).

Failure to meet any of the threshold values specified in the inclusion criteria.