Basic Treatment Program
The basic treatment program is usually done by telephone in six to twenty hourly sessions scheduled once per week or every other week. The first session consists of a general evaluation of your situation and an overview of suggestions about the best strategies to treat your particular problem with anxiety. The sessions after the initial evaluation follow The Anxiety & Phobia Workbook and generally address the following areas, though not necessarily in the order given below:
- Relaxation and abdominal breathing exercises
- Aerobic exercise
- Strategies for coping with panic attacks
- Setting goals and hierarchies for facing phobias (exposure therapy)
- Working with fearful self-talk and underlying core beliefs that drive fearful self-talk
- Looking at personality issues that underlie fear, such as the excessive need for control, excessive need for approval, perfectionism, etc.
- Working to reduce life stresses that aggravate anxiety problems, such as job stress, marital and family stress, health issues, and/ or other stressors
- Nutrition, diet and supplements
- Medication (your need for it or a review of what you are currently taking)
In the basic program, some attention is given to nutrition and health issues (diet and conditions that can affect anxiety such as adrenal exhaustion, food allergies, or seasonal affective disorder, for example).
You will be asked to do homework following each session. Success in overcoming anxiety problems depends upon you actively incorporating new behaviors, attitudes, and practices into your daily life.
The course of treatment is generally brief (i.e. six to twenty sessions), unless we have to address and work with deep seated personality issues, such as dependency, low self-esteem, excessive need to please, perfectionism, and so on. In some cases counseling could go on for longer when you've had a very traumatic history.
Beyond Basic Treatment
Sometimes more than cognitive-behavioral therapy and medication are needed to ensure the highest possible degree of recovery from an anxiety disorder. There are several other areas—outside the scope of standard treatments–that may impact your anxiety condition. For example, your life may be so complicated that you end up with preciously little down time to rest and rejuvenate yourself. Learning time management and other strategies to simplify your life may be needed. Or your diet may be aggravating your stress level, and thus your anxiety. While you may know to cut down on caffeine and sugar, even before coming in for therapy, you may be less aware of subtler dimensions of diet that can affect anxiety, such as food allergies, carbohydrate to protein ratio, candida, thyroid problems, mineral deficiencies, or heavy metal toxicity. Other areas that may influence your anxiety issues include your marital and family relationships, having a sense of purpose about your life, and your spiritual orientation and convictions. So, beyond the help you receive from cognitive behavioral therapy and medication, you may, for example, need to simplify your life, resolve marital difficulties, have a creative hobby or project that gives your life meaning, and/or deepen your trust and conviction in a Higher Power. All of these areas can affect your overall sense of well being and satisfaction with your life. As such, they are likely to significantly impact your anxiety symptoms, whether panic attacks, worries, or phobias.