Treating Anxiety From an Integrated Approach A Collaborative Approach to Care April 6, 2019 * Tex-CHIP Training Series

Medical Management of Anxiety

Understanding Provider Role in Treating Anxiety Psychiatric Mental Health Provider (MD, PMHNP, PA) Assessment Diagnosis Treatment planning Prescribing evidence-based psychological and pharmacological treatments for anxiety Psychoactive therapy/referral for outpatient therapy Evaluation of treatment

Considerations when Interacting with Clients Medical history Conditions, Prescriptions Psychiatric history Other mental health diagnosis Hospitalizations Substance abuse history Milieu

Our Treatment Plan Healthcare Domain: Primary Care Provider: Nurse Practitioner Objective- Decrease symptoms as indicated by client report of: (a) Sweating, chest pain, and dizziness (b) Difficulty focusing, feeling tense and fatigued (c) Excessive worry (d) Beck Anxiety Inventory score of 28 (severe anxiety)   Goals: a) Decrease symptoms b) Restore overall functionality Interventions: a) Benzodiazepine (short-term, therapy)/ SSRI b) Psychotherapy (CBT, DBT)

Measuring Outcomes/Success Patient report of decrease in overall symptoms Improvement in Beck Anxiety Inventory Score Collaborating with counselor on patient’s progress Monitoring medication compliance Pharmacy

Communication Needed from Counselors Patient progress Appointment compliance, short term/long term goals (in progress, completed) Changes in current symptoms (worsening, stagnant, improving) New symptoms, i.e. SI, HI, AVH, mood changes Interdisciplinary communication regarding pharmacological treatment goals