1. Copyright © 2002 by W. B. Saunders Company. All rights reserved. Chapter 14 Anxiety Disorders Menu F

2. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Mental health continuum for anxiety disorders 14-2 (Fig. 14-1) Menu FB

3. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. PET scan: Obsessive-Compulsive Disorder 14-3 (Fig. 14-3) From Lewis Baxter, MD, University of Alabama. Courtesy of the National Institutes of Mental Health. Menu FB

4. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Instruct to take slow, deep breaths l Keep expectations minimal and simple l Help connect feelings with attack onset l Help client recognize symptoms as anxiety, not a physical problem l Identify therapies l Teach abdominal breathing and positive self talk l Psychoeducation: medication l Instruct to take slow, deep breaths l Keep expectations minimal and simple l Help connect feelings with attack onset l Help client recognize symptoms as anxiety, not a physical problem l Identify therapies l Teach abdominal breathing and positive self talk l Psychoeducation: medication Panic Disorder: Interventions Menu FB

5. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Determine type of phobia and onset l Have client list consequences of contacting feared object l Identify therapies for phobias l Teach relaxation techniques l Model unafraid behavior l Determine type of phobia and onset l Have client list consequences of contacting feared object l Identify therapies for phobias l Teach relaxation techniques l Model unafraid behavior Phobia: Interventions Menu FB

6. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Anticipate needs, especially for information l Focus on client rather than on rituals l Monitor nutrition/sleep; encourage meals/rest l Avoid hurrying client l Do not arbitrarily forbid rituals; give positive reinforcement for non-ritualistic activity l Psychoeducation: medication, interrupting obsessive thoughts l Anticipate needs, especially for information l Focus on client rather than on rituals l Monitor nutrition/sleep; encourage meals/rest l Avoid hurrying client l Do not arbitrarily forbid rituals; give positive reinforcement for non-ritualistic activity l Psychoeducation: medication, interrupting obsessive thoughts Obsessive-Compulsive Disorder: Interventions Menu FB

7. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Stay with client l Speak slowly, using short and simple sentences l Assure client that nurse can assist him/her l Give brief explanations l Decrease stimuli l Administer anxiolytic if warranted l Encourage discussion of antecedent events l Encourage to link behavior to feelings l Teach cognitive therapy principles l Stay with client l Speak slowly, using short and simple sentences l Assure client that nurse can assist him/her l Give brief explanations l Decrease stimuli l Administer anxiolytic if warranted l Encourage discussion of antecedent events l Encourage to link behavior to feelings l Teach cognitive therapy principles Generalized Anxiety Disorder: Interventions Menu FB

8. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Question to clarify and dispute illogical thinking l Have client give alternative interpretations l Identify relief behaviors l Assist to reframe situation l Monitor own feelings l Question to clarify and dispute illogical thinking l Have client give alternative interpretations l Identify relief behaviors l Assist to reframe situation l Monitor own feelings Generalized Anxiety Disorder: Interventions, cont. Menu FB

9. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Assess type of trauma, immediate action, and later coping l Assess pre-trauma functioning, including drug and ETOH use l Assess post-trauma functioning, including drug and ETOH use l Explore shattered assumptions l Promote discussion of possible meanings of event l Suggest that client not responsible for event, but is responsible for coping l Identify social support and encourage use of support group l Assess type of trauma, immediate action, and later coping l Assess pre-trauma functioning, including drug and ETOH use l Assess post-trauma functioning, including drug and ETOH use l Explore shattered assumptions l Promote discussion of possible meanings of event l Suggest that client not responsible for event, but is responsible for coping l Identify social support and encourage use of support group Post-Traumatic Stress Disorder: Interventions Menu B