The aim was to explore the mismatch between therapeutic mechanisms and processes maintaining anxiety, leading to a taxonomy of mechanistic non-response.
Conducted a structured narrative review following SANRA principles.
Sourced literature from databases including PubMed, Scopus, and Cochrane between 2000 and 2026.
Organized psychotherapy mechanisms and anxiety maintenance factors based on synthesized evidence.
Identified six failure modes contributing to non-response, such as impaired inhibitory learning and cognitive rigidity.
Developed a clinical taxonomy linking failure signatures to mechanism-matched adaptations for treatment.
Proposed that non-response should lead to reformulation of therapeutic approaches rather than repeating interventions.