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Discussion 2: Treating Anxiety Disorder Essay SOCW 6443

Discussion 2: Treating Anxiety Disorder Essay

Discussion 2: Treating Anxiety Disorder Essay

Abstract

The Unified Protocol for Transdiagnostic Treatment (UP; Barlow et al., 2011) has recently demonstrated statistically equivalent therapeutic effects compared to leading cognitive behavioral therapy (CBT) protocols for anxiety disorders designed to address disorder-specific symptoms (i.e., single-disorder protocols [SDP]); Barlow et al., 2017). Although all treatment protocols included similar evidence-based CBT elements, investigation of those related to symptom improvement in the UP is warranted. Because the UP is unique from the SDPs for its inclusion of mindfulness, the present study evaluated mindfulness as a primary treatment element. We explored whether UP participants, compared to SDP, demonstrated greater improvements in mindfulness from pre- to posttreatment, and whether these improvements predicted posttreatment severity across anxiety disorder diagnoses. Participants were individuals with a principle anxiety disorder (N = 179) randomized to receive either the UP or SDP. Results indicated significant improvements pre- to posttreatment in mindfulness for participants receiving either the UP or SDP. However, at posttreatment, mindfulness scores were significantly greater for the UP condition. At the diagnosis level, posttreatment scores in mindfulness were significantly greater in the UP condition than the respective SDP conditions for principal Generalized Anxiety Disorder (GAD) and Social Anxiety Disorder (SOC). Moreover, results suggest that change in mindfulness is related to posttreatment severity, when moderated by treatment condition, but only for participants with principal GAD. Taken together, the UP is effective in improving mindfulness in a sample with heterogeneous anxiety disorders, but this change seems particularly relevant for reduction in symptom severity for individuals with principal GAD. https://doi.org/10.1016/j.beth.2020.01.001

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Anxiety levels range dramatically from individual to individual and from situation to situation. To illustrate the spectrum of normal to psychopathological anxiety, consider the fear of dogs. Many people are reasonably cautious when encountering an unfamiliar dog, rationalizing that the animal has some potential to inflict injury and will therefore not approach an unattended dog. However, some people avoid even the possibility of encountering a dog by never leaving their homes. In addition, some people may turn to available substances, such as alcohol, to self-medicate to overcome their fear, creating the potential for developing a comorbid addictive disorder. In short, anxiety disorders present a complex range of challenges for the mental health professional and require a multifaceted approach in creating treatment strategies.

For this Discussion, view the media case studies “Anxiety Disorder Case Study: Willy” and “Anxiety Disorder Case Study: June.” Select one case study and consider the general challenges in assessment, differential diagnosis, and use of psychopharmacological treatment for the symptoms demonstrated. Think about the uses and benefits of anxiolytic medications in the treatment of panic disorders, phobias, obsessive-compulsive disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder, and social anxiety.

  • Post the challenges of treating the anxiety disorder of the client you selected.
  • Then describe at least three potential anxiolytic medications that may be effective in treating this client and explain the potential addiction risk of each.
  • Explain how this information might influence a mental health professional’s approach to counseling this client.
  • Finally, explain the role of the mental health professional in communicating concerns to other health care professionals.

Anxiety Disorder Case Study: Willy

Program Transcript

WILLY: My name is Willy. I’m 35 years old. I’ve been divorced for five years and I don’t have any  children. I am not seeing anyone at the moment.

My biggest problem is reliving events from my past. I joined the army when I was 18 years old. I love the structure of military life and the resources the army provided. I enjoyed the educational opportunities. And I also knew I would have a roof over my head and something to eat.

I was doing well in the military. So I stayed in for about 10 years. During that time, the US became involved in a number of foreign conflicts and initiatives. I was deployed to Afghanistan during one of my last years in the army.

In Afghanistan, my perspective on what I was accomplishing shifted dramatically.

In one instance, I witnessed my best, most trusted friend shoot a young, unarmed girl just because she wore hijab. My fears after witnessing this event changed me forever. I became disenchanted with the army as I thought about all the people who were killed.

In the face of that girl, I saw my sister’s daughter, Heather. It seems now that every night I had dreams of war and genocide. Occasionally, during the worst times, I thought about whether it would have been better for me to have died in that country instead of returning to this miserable life. I wonder every day, if I had turned in my friend, would I not be haunted by this girl’s memory.

I panic at some point most days. I become agitated and lash out when my mind is on the past. It interferes with my work and my relationships with my coworkers.

After I calm down, I tell myself that it doesn’t make sense for me to be panicking.

But I know it will happen again. Sometimes, I’m afraid I might hurt someone if they startle me.

References (use 3 or more)

Laureate Education (Producer). (2012c). Anxiety disorder case study: Willy: Post traumatic stress disorder [Video file]. Baltimore, MD: Author.

Lichtblau, L. (2011). Psychopharmacology demystified. Clifton Park, NY: Delmar, Cengage Learning.

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of clinical psychopharmacology for therapists (8th ed.). Oakland, CA: New Harbinger.

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Retrieved from the Walden Library databases.

American Psychiatric Association. (2013). Highlights of changes from DSM IV-TR to DSM-5. Retrieved from http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf