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

2. Treating Anxiety Through Counseling

3. Understanding Provider Role in Treating Anxiety
Informal versus Formal Assessment. Clinical interview and brief assessment.
Many brief symptom checklists only screen for generalized anxiety disorder and panic symptoms not social anxiety, PTSD, phobias, or OCD.

4. Considerations when Interacting with Clients
Understand that clients have their own interpretation of their anxiety symptoms and reactions to these symptoms (e.g., fear, shame, confusion, resignation, overwhelmed, hopeless).
Importance of communicating empathy for their struggle, emphasizing strengths, and challenging stigma related to mental health issues.
There is often comorbidity of anxiety with other diagnoses.
Often anxious individuals are highly motivated to feel better and want to understand their symptoms.
Some clients with anxiety may have a history of “self-medicating” with alcohol or other drugs or food.
Avoidance is a common coping mechanism

5. Our Treatment Plan Healthcare Domain: Behavioral Health Provider: LPC
Objective:
Decrease symptoms as indicated by client report of:
(a)Loss of relationship
(b)Daily functioning impairment
(c)Excessive worry
(d) Avoidant behavior
Goals:
a)  Teach Stephanie how to better manage anxiety symptoms to improve her daily functioning through the implementation of the Cognitive Model.
b) Explore dysfunctional behaviors and core beliefs and how they might be interfering with Stephanie’s work performance.
c)  Medication management and diagnosis education.
Interventions:
Psychoeducation 
Cognitive Model
b)  Self-monitoring

6. Measuring Outcomes/Success
Administering Beck Anxiety Inventory at regular intervals to track reduction in symptoms
Pay attention to client’s subjective description of how they are feeling and functioning
Goal is for client to learn to effectively manage anxiety symptoms which typically results in a reduction in the severity and frequency of symptoms.
Important that client understands that treatment won’t eliminate anxiety completely.

7. Communication Needed From Other Providers
If symptoms aren’t getting better, discuss with treatment team. Does treatment plan need to be modified? Consider other contributing factors (e.g., environmental factors, personality disorder, health issues, medication).
Case Manager- can provide Stephanie with resources
Psychiatrist- can make medication changes/adjustments
Primary Care Doctor- can address/rule out health issues
Psychiatric Nurse- can provide medication education
Psychologist- can conduct additional assessment if needed