Generalized anxiety disorder is increasingly being recognized as a considerable mental health concern. However, it remains a poorly understood and insufficiently treated chronic disorder. Recent conceptualizations have highlighted the role of emotion acceptance, utilization and management as a core feature of the disorder. An emotion regulation perspective may shed light on treatment approaches to GAD. An integrative approach to treating GAD, entitled Emotion Regulation Therapy (ERT) is presented through the case of a young woman. ERT addresses cognitive, emotional and contextual factors of GAD and is divided into four phases: (1) psychoeducation, monitoring and developmental history; (2) skills training in somatic awareness and emotional knowledge, utilization and regulation; (3) use of these skills to confront core thematic issues using experiential exposure exercises; (4) and progress review, relapse prevention and termination processing. ERT was shown to successfully treat symptomatic, functional and qualitative aspects of the case presented, suggesting a future direction for therapeutic investigation of GAD. Copyright © 2004 John Wiley & Sons, Ltd.