Psychotherapy

Psychotherapy is often the treatment of choice for many anxiety disorders, and may include cognitive-behavioral therapy, relaxation training, assertiveness training, and psycho-education. In addition, psychotropic medication, meditation, and exercise are also considered to be very beneficial.

Treatment

The cognitive model introduced by Beck suggests that anxiety is triggered when people overestimate the danger in certain situations, or underestimate their coping response. The treatment is a collaborative venture between the therapist and the client, where the therapist gently challenges the client’s incorrect assumptions, automatic thoughts, or faulty reasoning. The client accelerates the treatment by practicing new tools, connecting what is learned in therapy to the challenges of everyday life. Cognitive-behavioral therapy can also be very creative, and through personalized treatment, the therapist can tailor certain techniques to serve each individual’s needs. The good news is that there is generally a “formula” or “map” that maximizes successful outcomes in treatment.

Cognitive-Behavioral Techniques

In cognitive-behavioral therapy, clients learn that anxiety is largely the result of beliefs and expectations, not the situation itself. Specific tools or techniques may be used to manage anxiety, such as: overcoming avoidance; identifying cognitive distortions or automatic thoughts; controlled breathing; progressive relaxation; examining core beliefs; and separating situations, moods and thoughts. Progressive “exposures” to the feared stimulus are often combined with effective coping skills, and this offers the client an experience of gradual accomplishment.

Evidence-based techniques that are used in therapy are grounded in psychological research. Quantitative measures such as screeners, questionnaires and assessment tools can also be used to measure therapeutic progress and evaluate the course of treatment. This ongoing assessment increases the likelihood that therapy will be effective.

The following is a list of common anxiety disorders:

Panic Disorder

Panic Disorder may be described as a “fear of fear.” It is the presence of recurrent, unexpected panic attacks followed by at least one month of persistent concern over having another panic attack. A panic attack is a discrete period (20-30 minutes, maximum) in which there is a sudden onset of intense apprehension, fearfulness, or terror, often associated with feelings of impending doom. During these attacks, the following symptoms may be present: shortness of breath, heart palpitations, chest pain or pressure, choking or smothering sensations, feelings of unreality, or fear of dying, going crazy or losing control.

Agoraphobia

Agoraphobia is the avoidance of places or situations from which escape might be difficult or embarrassing, or in which help may not be available in the event of having a panic attack or panic-like symptoms. An agoraphobic client may avoid things like freeways, parties, or the grocery store, and is not necessarily “house bound.”

Obsessive-Compulsive Disorder

OCD is characterized by persistent, unwanted thoughts (obsessions), and/or repetitive behaviors, rituals or mental acts (compulsions). Obsessions may be felt to be unreasonable or excessive, yet despite the presence of insight the individual feels unable to prevent the disturbing thoughts. Compulsions may temporarily neutralize or alleviate anxiety, and these behaviors can include cleaning, hand washing, counting, checking, repeating, or hoarding.

Social Phobia

Social Phobia (or Social Anxiety Disorder) is characterized by extreme anxiety about being judged or ridiculed by others, or a fear of behaving in a way that might cause embarrassment. Social phobia may be specific to certain types of social or performance situations, often leading to avoidance behavior (e.g., public speaking).

Specific Phobia

Specific Phobia is a marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). It is not primarily social in nature.

Generalized Anxiety Disorder

Generalized Anxiety Disorder is experienced as pervasive, persistent and excessive anxiety that lasts for at least six months.