Anxiety Treatment

Medication may be recommended as an adjunct intervention to manage the symptoms of anxiety and improve the outcome of the treatment. In some cases, healthcare providers prescribe medication, particularly Serotonin Reuptake Inhibitors (SSRIs), because they are more effective and have a lower risk of side effects and dependence. SSRI works by blocking the neurotransmitter serotonin reabsorption and increasing its level in the brain.

Another science-backed form of intervention that we use to treat anxiety disorders is Dialectical Behavioural Therapy (DBT). It is a type of CBT that integrates mindfulness principles and embraces the concept of pairing opposing strategies of acceptance and change. Through DBT, individuals can learn to recognise their emotions, how they feel them, and what skills are essential to cope with them. In addition, DBT also teaches individuals skills to improve their interpersonal relationships.

The highly structured and goal-driven approach of DBT operates based on the following core modules when treating anxiety disorders:

• Mindfulness: Individuals learn how to become aware of their thoughts, emotions, behaviours, and sensations. This allows them to stay in the present moment and accept unpleasant events.
• Distress Tolerance: This module focuses on teaching individuals to develop resilience when experiencing anxious feelings. Strategies such as paired muscle relaxation, acceptance skills, paced breathing, changing body temperature, and intense exercise are introduced.
• Emotion Regulation: The therapist guides individuals to recognise the intense emotions associated with anxiety and modulate them through various strategies. The therapist teaches STOP skills, PLEASE skills, ABC skills, positive affirmations, and opposite actions.
• Interpersonal Effectiveness: The primary goal of this module is to equip individuals with the ability to create healthy relationships, maintain them, and terminate those toxic relationships. The therapist teaches individuals the DEARMAN approach, which stands as an acronym for describe, express, assert, reinforce, mindful, act confident, and negotiate, which helps individuals strike efficient communication to improve interpersonal relationships.

Cognitive Behavioural Therapy (CBT) is one of the gold standard treatments for various mental conditions, including anxiety disorders. It is a directive, structured, and goal-oriented form of talk therapy that explores the relationship between our thoughts, emotions, and behaviours. The primary objective of CBT is to reduce distress by developing more adaptive cognitions and behaviours.

CBT is based on the cognitive model of mental illness, where our feelings and actions are determined by the way we think. Hence, the therapist and the individual work collaboratively to recognise these faulty thoughts that cause and maintain distress. The following CBT techniques can be used when treating anxiety disorders:

• Psychoeducation: The initial phase of CBT begins with psychoeducation. It is an integral part of the successful treatment of anxiety disorders because this is where individuals are taught about the symptoms and aetiology of anxiety, what maintains the problem, and how to manage anxiety symptoms in the long term.
• Thought Records: This is an activity that helps individuals become aware of unhealthy thinking patterns or cognitive distortions. It works by writing in a worksheet the situation, automatic thoughts, feelings about it, and evidence to support the thought. Some of the most commonly identified unhelpful thoughts for people with anxiety disorder include thinking about the worst-case scenario (catastrophizing) and drawing conclusions based on little to no evidence at all (generalisation).
• Cognitive Restructuring: Once the cognitive distortions associated with anxiety are captured, the therapist assists the individual in challenging them. The therapist performs Socratic questioning and de-catastrophising techniques to encourage the individual to modify, change, and replace those distortions with a more rational way of thinking.
• Behaviour Techniques: The therapist introduces various techniques to help the individual change the behavioural patterns associated with anxiety. These techniques include exposure, behavioural activation, and activity scheduling. 

In addition to individual or one-on-one interventions, Liberty Home Clinic also offers group therapy for individuals with anxiety disorders. It is a therapeutic space that provides a supportive atmosphere for them to share their experiences about anxiety—how they struggle and cope with it. The therapist moderates the discussion while the participants learn from each other. In our treatment centre, individuals can join our cognitive-behavioural groups, support groups, self-help groups, counselling groups, dynamic group therapy, relapse prevention groups, or interpersonal process groups.