WEEK 9: ANXIETY DISORDERS (TREATMENTS)

 The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with cognitive-behavioral therapy, medication, or some combination of the two.

SYSTEMATIC DESENSITIZATION  Systematic desensitization is a technique which is used to help people manage and eventually conquer phobias  An individual learn to handle progressively more disturbing stimuli while they remain relaxed  About 10 – 20 stimuli are arranged in a hierarchy (fear stimulus hierarchy)

 Assumption (Joseph Wolpe, 1958) – maladaptive anxiety responses, like other behaviors are learned or conditioned. They can be unlearned by conterconditioning.  Advantages of systematic desensitization are: - enhance self-efficacy expectancies - lower catecholamine levels - help people overcome phobias through a stepwise approach of actual exposure to the phobic stimuli

The procedures of systematic desensitization 1. Begins with the collection of a history of the patient’s problem 2. The problem is explained to the patient 3. Explain the rationale of systematic desensitization 4. Train the patient with relaxation techniques 5. Establish an anxiety hierarchy 6. Imagery desensitization

 Phobia About Driving on Freeways 1. Watching from a distance as cars drive past on the freeway 2. Riding in a car on the freeway with someone else driving 3. Driving on a freeway the distance of one exit with a friend sitting next to you at a time when there is a little traffic 4. Driving the distance of one exit with a friend when the freeway is busier 5. Repeat step 3 alone 6. Repeat step 4 alone

7. Driving the distance of two exits with a friend sitting next to you at a time when there is little traffic 8. Driving the distance of two exits with a friend sitting next to you at a time when there is moderate traffic 9. Repeat step 7 alone 10. Repeat step 8 alone

 Phobia about giving presentation 1. Preparing a talk which you don’t give 2. Preparing a talk and delivering it in front of one friend 3. Preparing a talk and delivering it in front of three friend 4. Giving a brief presentation to three or four people at work who you know well 5. Same as Step 4 but a longer presentation 6. Giving a brief presentation to people 7. Same as Step 6 but a longer presentation 8. Giving a brief presentation to 3 or 4 strangers 9. Same as step 8 but a longer presentation 10. Giving a brief presentation to 10 – 15 strangers 11. Giving a brief presentation to 50 strangers

Cognitive Techniques  Rational restructuring Much maladaptive behavior is determined by the assumptions people make about the world In this rational restructuring, argument or discussion may be used in an attempt to get patients to see the irrationality of their belief The therapist may attempt to teach them to modify their internal sentences

 Rational Emotive Therapy (RET) Ellis (1962) RET aims to change behavior by altering the way the patient thinks about things ABC – Beliefs (B) about activating events or situations (A) that determine the problematic emotional or behavioral consequences (C)

 Behavioral Treatment of Social Phobia Flooding Method (exposure therapy)  Behavioral Treatment of Agoraphobia Exposure Therapy - gradual exposure to fear- inducing stimuli  Behavioral Treatment to PTSD Exposure Therapy  Behavioral Treatment for OCD Exposure with response prevention

Complementary treatments for anxiety disorders  Exercise – Exercise is a natural stress buster and anxiety reliever. Research shows that as little as 30 minutes of exercise three to five times a week can provide significant anxiety relief. To achieve the maximum benefit, aim for at least an hour of aerobic exercise on most days.  Relaxation techniques – When practiced regularly, relaxation techniques such as mindfulness meditation, progressive muscle relaxation, controlled breathing, and visualization can reduce anxiety and increase feelings of relaxation and emotional well-being.  Biofeedback – Using sensors that measure specific physiological functions—such as heart rate, breathing, and muscle tension—biofeedback teaches you to recognize the body’s anxiety response and learn how to control them using relaxation techniques.  Hypnosis – Hypnosis is sometimes used in combination with cognitive-behavioral therapy for anxiety. While you’re in a state of deep relaxation, the hypnotherapist uses different therapeutic techniques to help you face your fears and look at them in new ways.