Healthcare Training Institute - Quality Education since 1979
Psychologist, Social Worker, Counselor, & MFT!!

Section 1
Track #1 - Introduction

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Welcome to the Home Study Course sponsored by the Healthcare Training Institute, homestudycredit.com.  This course is dealing with Behavioral and Cognitive Strategies for Treating Anxiety.

Our primary intent for this home study course is to provide quality education to foster your professional growth.  The Institute has provided quality education since 1979.
 
Hi.  My name is James Brennen.  I will be the narrator of this CD set.  We appreciate that you have chosen us as a vehicle for you to earn your Continuing Education Credit.

The purpose of the course is to assist you in increasing your knowledge regarding how to treat patients, clients, etc. dealing with anxiety.  As each case study is given, if the concepts seem to be applicable to your situation, I encourage you to turn your CD player off and make a few notes regarding the application of the principle to your setting.  However, these notes are for your purposes only and are not to be sent to the Institute.  Also each track is very content dense.  So feel free to replay the track to review the content either for your own purposes, or if you feel appropriate play the track in an individual or group session for client education.  Also permission is granted to reproduce this CD.  We encourage you to duplicate and give copies of this CD to colleagues, clients, etc. as you deem appropriate. We feel the information on our CD's is valuable.  Thus, we have an interest in distributing CD's in as many ways as possible, to benefit the greatest number of people, who have a need and are receptive to this practical information.

The questions in your Answer Booklet are sequential and deal with the section of content that preceded it.  For this reason, to facilitate the answering of each question, you might read the question from the Answer Booklet prior to listening to that CD track.  By knowing what the question is ahead of time, you will then know the content to listen for that contains the answer.  So just a hint, after you write down the answer to a question in your Answer Booklet, read on to the next question in order to give you a “heads up” to listen for the content that contains the answer to the next question.

Merely write the correct letter on the corresponding blank line in your answer booklet. Each answer is only used once. Keep in mind there is nothing tricky or hard about these questions.  They are merely intended to verify the playing of this CD.

For the purpose of brevity, most generally, I will use the term “therapists” or “mental health professional.”  However, don’t let these terms deter you from applying the concepts to your situations.  When you hear the word “therapists,” if your job title is social worker, psychologist, marriage and family therapist, mental health counselor, professional counselor, resident director, program assistant, etc. merely substitute the appropriate term that is the most meaningful to you. In short, don’t let my use of the term “therapists” cognitively set you off track from hearing the content because your job title is school counselor, for example.  I will also use the term “client” for the purposes of brevity.  However, if you deal with patients, residents, students, consumers, etc., transpose “client” for the term that is the most meaningful to you in your work setting. 

On this CD set we will discuss such topics as: watching worries come and go, mirror anxiety, accepting reality, uncertainty training, overriding obsessive anxiety, past redemption, if only’s, assertiveness training, treating phobic conditions, successive approximations, managing anxiety with humor, and treatment goals for recovery.

So  let’s get started

On this track we will discuss detecting and exposing anxiety.  In your practice, how many of your clients arrive for their first session already aware and accepting of their anxiety?  Probably not many.  Therefore, the purpose of this track is to provide three techniques you can use to help your client detect and expose anxiety.  The three techniques on this track are analyzing and attacking anxiety by discussing the costs of anxiety, cognitive therapy, and clearing roadblocks to change.  As you listen to this track, you might consider playing it for a client you are treating for anxiety. 

#1  Analyzing and Attacking Anxiety
First, let’s discuss analyzing and attacking anxiety.  Even when unaware clients talk about their feelings, some of the words in these examples are clear indications of anxiety.  Rob, age 31, stated, “I can’t come up with the words to describe my feelings.  It’s like dread and doom but a thousand times worse.  I want to scream, cry for help, but I’m paralyzed.  It’s the worst feeling in the world.”  Clearly, Rob suffered from panic attacks.  Another client, Haley, age 22, stated, “I’m lonely.  I’ve always been painfully shy.  I want friends, but I’m too embarrassed to call anyone.  I guess I feel like anyone I call will think I’m not worth talking to.”  As you know, Haley was experiencing symptoms of social phobia or social anxiety disorder.  What type of anxiety does your client indicate that he or she may have?

Technique:  Discussing the Costs of Anxiety and Cognitive Therapy
After analyzing a client’s anxiety, it is time to attack.  This course will provide a number of therapeutic interventions for anxiety, but I find that a good initial technique for getting clients to face anxiety is to simply discuss the costs of anxiety.  Obviously, clients with anxiety feel as they put it “lousy.”  I have found that it can be productive to inform clients of some of the other ways they can be affected by anxiety.  Think of your Rob or Haley.  Could he or she benefit from considering costs of anxiety such as the physical toll, damage to children, weight gain and other health problems, or relationship problems? 

Or do you have a client like Leah who could benefit from an immediate cognitive therapy intervention?  Leah, a college sophomore, got physically ill before every exam.  Leah threw up, had diarrhea, and experienced mild tachycardia.  Leah stated, “I’m so worried I’m going to fail each and every test I take.  Then I’ll get kicked out of school.  What would happen to me then?”  Clearly, a cognitive approach to Leah would involve helping her capture the negative predictions and catastrophic outcomes that run through her mind.  I asked, “What is your typical test grade?”  After Leah answered, I followed up my asking her about her lowest test grade.  Leah reported a B average with her lowest grade being a B minus.  Think of your Leah.  How might you guide your client to search for evidence about her true performance and a more realistic appraisal of the chances of her actually failing?  More information on cognitive therapy interventions for anxiety will be discussed later in this course.

#2  Clearing the Roadblocks to Change
In addition to analyzing and attacking anxiety initially, another productive technique in the early stages of therapy may be clearing the roadblocks to change.  Would you agree that this may prove to be an ongoing technique with some of your anxiety clients?  As you know, three major causes of anxiety are genetics, parenting, and trauma.  Regarding parenting, three parenting styles appear to foster anxiety in children.  These include overprotective, over controlling, and inconsistent parenting.  After identifying your client’s cause of anxiety, perhaps you might try to help him or her clear the roadblocks to change by moving form self abuse to self acceptance.  Rob, whose anxiety was the result of a panic disorder, also felt deep shame that someone like him was experiencing anxiety.  Rob stated, “A real man would never have this kind of problem.”  In order to help Rob be more self-forgiving, I first asked him to write down the three major causes of his anxiety.  Over the course of several days, Rob reviewed his life and came up with as many possible contributors to his worries as he could.  Examples of possible genetic influences that Rob identified were several family members including a short description of associated behavior.  Rob described parenting as a contributing factor when he identified his father’s unpredictable temper.  Rob also described his mother as ‘moody.’  The third major cause of anxiety Rob listed were events in his life.  For example, Rob listed a traumatic car accident when he was 6, his first marriage ending in divorce due to his wife’s unfaithfulness, and his recent diagnosis of diabetes. 

Next, Rob and I reviewed his finished list.  I asked, “Do you think are to blame for your worries?”  Rob stated, “After making this list, I realize a lot has happened to me.  But I don’t want to play the victim.”  I asked Rob to be realistic and consider what percentage of his anxiety belonged to him and what percent could be attributed to genes, parenting, and past events.  Do you find that your clients, like Rob, become more willing to move from self abuse to self acceptance after clearing the roadblocks to change?

On this track we have discussed detecting and exposing anxiety.  The purpose of this track was to provide three techniques you can use to help your client detect and expose anxiety.  The three techniques on this track were analyzing and attacking anxiety by discussing the costs of anxiety, cognitive therapy, and clearing roadblocks to change.

QUESTION 1
What are three techniques for detecting and exposing anxiety? To select and enter your answer go to Answer Booklet.