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

Role of Case Management in Treating Anxiety

Understanding Provider Role in Treating Anxiety Supportive role Education for client and support system Diagnosis education Enabling coping skills vs positive coping skills Real-time applications of the skills learned in therapy Symptoms tracking and reporting Encouraging self-reporting Effective documentation from case manager to team

Considerations when Interacting with Clients Similarities across Anxiety Disorder diagnoses Fear, Anxiety, &/or Avoidance Current coping skills and patterns of learned behaviors Separating appropriate coping skills may be difficult depending on how the skills effect anxiety symptoms Case Manager as a potential primary enabler? Potential difficulties of comorbidity with other diagnoses Maintaining compassionate curiosity with difficult symptoms and potential for slow/selective progress

Our Treatment Plan Healthcare Domain: Behavioral Health Provider: Case Manager Objective: Decrease in symptoms as indicated by client report of: (a) Reduction “always on edge” feeling (b) Reduction in “exposed and vulnerable” feelings (c) Increase outings (d) Improve reports of worry   Goals: a)  Resume daytime activities b) Purchase food/groceries in person at a brick & mortar location c)  Resume enjoyable activities outside her home Interventions: a)  Deep breathing techniques b) Desensitization of anxiety symptoms   c) Normalization of anxiety symptoms across scenarios

Measuring Outcomes/Success Increased positive/desired behaviors Engaging in the (formerly) anxiety provoking situation without using current enabling coping skills Decreased negative/unwanted behaviors Engaging in the (formerly) anxiety provoking situation without or with decreased anxiety symptoms

Communication Needed from Counselors Specifics of the needs as related to the presenting symptomology Identification of successes and challenges reported in session(s) Concrete identification of skills to build or strengths to utilize in case management planning Any positive or negative influence from primary support group or natural supports Risk factors, or triggers for increased risk Include related safety plan and emergency procedures