Abstract
Numerous assessment instruments and treatments for anxiety are feasible to administer in primary care settings. Available treatment delivery formats include psychoeducation, bibliotherapy, and computer-based interventions, all of which provide cost-effective alternatives to intensive outpatient individual psychotherapy. A growing body of empirical research supports the effectiveness of these interventions. After a brief review of the available research, specific interventions are described and recommendations for triage are made. Finally, directions for future research and dissemination are discussed.
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References
Allen LB, McHugh RK, Barlow DH. Emotional disorders: a unified protocol. In: Barlow DH, editor. Clinical handbook of psychological disorders: a step-by-step treatment manual. 4th ed. New York: Guilford; 2007. p. 216–49.
Andersson G, Bergström J, Carlbring P, Lindefors N. The use of the internet in the treatment of anxiety disorders. Curr Opin Psychiatry. 2005;18:73–7.
Antony MM, Craske MG, Barlow DH. Mastering Your Fears and Phobias: Workbook. 2nd ed. New York: Oxford University Press; 2006.
Baillie A, Rapee RM. Predicting who benefits from psychoeducation and self help for panic attacks. Behav Res Ther. 2004;42:513–27.
Barlow DH, Allen LB, Choate ML. Toward a unified treatment for emotional disorders. Behav Ther. 2004;35:205–30.
Barlow DH, Craske MG. Mastery of your anxiety and panic: client workbook. 4th ed. New York: Oxford University Press; 2006.
Brown TA, DiNardo PA, Barlow DH. Anxiety disorders interview schedule for DSM-IV (ADIS-IV). San Antonio, TX: Psychological Corporation; 1994.
Dobscha SK, Corson K, Gerrity MS. Depression treatment preferences of VA primary care patients. Psychosomatics. 2007;48:482–8.
Eisenthal S, Emery R, Lazare A, Udin H. “Adherence” and the negotiated approach to patienthood. Arch Gen Psychiatry. 1979;36:393–8.
Febbraro GA, Clum GA, Roodman AA, Wright JH. The limits of bibliotherapy: a study of the differential effectiveness of self-administered interventions in individuals with panic attacks. Behav Ther. 1999;30:209–22.
First MB, Spitzer RL, Gibbon M, Williams JBW. Structured clinical interview for DSM-IV-TR Axis I disorders. New York: Biometrics Research Department, New York State Psychiatric Institute; 2001.
Ghosh A, Marks IM. Self-treatment of agoraphobia by exposure. Behav Ther. 1987;18:3–16.
Hayward L, MacGregor AD, Peck DF, Wilkes P. The feasibility and effectiveness of computer-guided CBT (FearFighter) in a rural area. Behav Cogn Psychoth. 2007;35:409–19.
Hazlett-Stevens H. Assessment and treatment of anxiety in primary care. In: James LC, O’Donohue WT, editors. The primary care toolkit: Practical resources for the integrated behavioral care provider New York: Springer; 2009. p.169–82.
Hazlett-Stevens H. Women who worry too much: how to stop worry and anxiety from ruining relationships, work, and fun. Oakland, CA: New Harbinger; 2005.
Hazlett-Stevens H, Craske MG. Brief cognitive-behavioral therapy: definition and scientific foundations. In: Bond FW, Dryden W, editors. Handbook of brief cognitive behaviour therapy. New York: Wiley; 2002. p. 1–20.
Hazlett-Stevens H, Craske MG, Roy-Byrne PP, Sherbourne CD, Stein MB, Bystritsky A. Predictors of willingness to consider medication and psychosocial treatment for panic disorder in primary care patients. Gen Hosp Psychiatry. 2002;24:316–21.
Houghton S, Saxon D. An evaluation of large group CBT psycho-education for anxiety disorders delivered in routine practice. Patient Educ Couns. 2007;68:107–10.
Kobak KA, Taylor LH, Dottl SL, Greist JH, Jefferson JW, Burroughs D, Mantle JM, Katzelnick DJ, Norton R, Henk HJ, Serlin RC. A computer-administered telephone interview to identify mental disorders. J Am Med Assoc. 1997;278:905–10.
Lindren DM, Watkins PL, Gould RA, Clum GA, Asterino M, Tulloch HL. A comparison of bibliotherapy and group therapy in the treatment of panic disorder. J Consult Clin Psychol. 1994;62:865–9.
Marks IM, Kenwright M, McDonough M, Whittaker M, Mataix-Cols D. Saving clinicians’ time by delegating routine aspects of therapy to a computer: a randomized controlled trial in phobic/panic disorder. Psychol Med. 2004;34:9–17.
McNamee G, O’Sullivan G, Lelliott P, Marks I. Telephone-guided treatment for housebound agoraphobics with panic disorder: exposure vs. relaxation. Behav Ther. 1989;20:491–7.
Newman MG, Erickson T, Przeworski A, Dzus E. Self-help and minimal-contact therapies for anxiety disorders: is human contact necessary for therapeutic efficacy? J of Clin Psychol. 2003;59:251–74.
Newman MG, Holmes M, Zuellig AR, Kachin KE, Behar E. The reliability and validity of the panic disorder self-report: a new diagnostic screening measure of panic disorder. Psychol Assessment. 2006;18:49–61.
Newman MG, Kachin KE, Zuellig AR, Constantino MJ, Cashman-McGrath L. The social phobia diagnostic questionnaire: preliminary validation of a new self-report diagnostic measure of social phobia. Psychol Med. 2003;33:623–35.
Newman MG, Zuellig AR, Kachin KE, Constantino MJ, Przeworski A, Erickson T, Cashman-McGrath L. Preliminary reliability and validity of the generalized anxiety disorder questionnaire-iv: a revised self-report diagnostic measure of generalized anxiety disorder. Behav Ther. 2002;33:215–33.
Norton PJ. An open trial of a transdiagnostic cognitive-behavioral group therapy for anxiety disorder. Behav Ther. 2008;39:242–50.
Proudfoot JG. Computer-based treatment for anxiety and depression: is it feasible? Is it effective? Neurosci and Biobehav Rev. 2004;28:353–63.
Rapee RM, Abbott MJ, Lyneham HJ. Bibliotherapy for children with anxiety disorders using written materials for parents: a randomized controlled trial. J Consul Clin Psychol. 2006;74:436–44.
Raue P, Schulberg H.C. Psychotherapy and patient preferences for the treatment of major depression in primary care. In: Henri MJ, editor. Trends in depression research. Hauppauge, NY: Nova Science Publishers; 2007. p. 31–51.
Reeves T, Stace JM. Improving patient access and choice: assisted bibliotherapy for mild to moderate stress/anxiety in primary care. J Psychiatr Mental Health Nurs. 2005;12:341–6.
Roy-Byrne PP, Craske MG, Stein MB, Sullivan G, et al. A randomized effectiveness trial of cognitive behavior therapy and medication for primary care panic disorder. Arch Gen Psychiatry. 2005;62:290–8.
Schulberg HC, Block MR, Madonia MJ, Scott CP, et al. Treating major depression in primary care practice: eight-month clinical outcomes. Arch Gen Psychiatry. 1996;53:913–9.
Sheehan DV, Lecrubier Y. MINI International Neuropsychiatric Interview for DSM-IV (English Version 5.0.0). Tampa: University of South Florida; 2002.
Sheehan DV, Lecrubier Y, Harnett-Sheehan K, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl. 20):22–33.
Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. J Am Med Assoc. 1999;282:1737–74.
Spitzer RL, Williams JBW, Kroenke K, Linzer M, deGruy FV, Hahn SR, Brody D, Johnson JG. Utility of a new procedure for diagnosing mental disorders in primary care: The PRIME-MD 1000 study. J Am Med Assoc. 1994;272:1749–56.
Sullivan G, Craske MG, Sherbourne C, Edlund MJ, et al. Design of the Coordinated Anxiety Learning and Management (CALM) study: innovations in collaborative care for anxiety disorders. Gen Hosp Psychiatry. 2007;29:379–87.
Swinson RP, Fergus KD, Cox BJ, Wickwire K. Efficacy of telephone-administered behavioral therapy for panic disorder with agoraphobia. Behav Res Ther. 1995;33:465–9.
Titov N. Status of computerized cognitive behavioural therapy for adults. Aust N Z J Psychiatry. 2007;41:95–114.
van Schaik DJF, Klijn AFJ, van Hout HPJ, van Marwijk HWJ, et al. Patients’ preferences in the treatment of depressive disorder in primary care. Gen Hosp Psychiatry. 2004;26:184–9.
Wright J, Clum GA, Roodman A, Febbraro GA. A bibliotherapy approach to relapse prevention in individuals with panic attacks. J Anxiety Disord. 2000;14:483–99.
Yonkers KA, Bruce SE, Dyck IR, Keller MB. Chronicity, relapse, and illness—Course of panic disorder, social phobia, and generalized anxiety disorder: Findings in men and women from 8 years of follow-up. Depress Anxiety. 2003;17:173–9.
Zimmerman M, Mattia JI. The reliability and validity of a screening questionnaire for 13 DSM-IV Axis I disorders (the psychiatric diagnostic screening questionnaire) in psychiatric outpatients. J Clin Psychiatry. 1999;60:677–83.
Zimmerman M, Mattia JI. The psychiatric diagnostic screening questionnaire: development, reliability, and validity. Compr Psychiatry. 2001a;42:175–89.
Zimmerman M, Mattia JI. A self-report scale to help make psychiatricdiagnoses: The psychiatric diagnostic screening questionnaire (PDSQ). Arch Gen Psychiatry. 2001b;58:787–94.
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Hazlett-Stevens, H. (2011). Anxiety. In: Draper, C., O'Donohue, W. (eds) Stepped Care and e-Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6510-3_3
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