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Chapter 14
Anxiety Disorders
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
F
Mental health continuum for anxiety disorders
(Fig. 14-1)
Slide 14-2
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
PET scan: Obsessive-Compulsive Disorder
(Fig. 14-3)
Slide 14-3
From Lewis Baxter, MD, University of Alabama. Courtesy of the National Institutes of Mental Health.
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
B
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F
Panic Disorder: Interventions

Instruct to take slow, deep breaths

Keep expectations minimal and simple

Help connect feelings with attack onset

Help client recognize symptoms as anxiety, not a physical
problem

Identify therapies

Teach abdominal breathing and positive self talk

Psychoeducation: medication
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Phobia: Interventions

Determine type of phobia and onset

Have client list consequences of contacting feared object

Identify therapies for phobias

Teach relaxation techniques

Model unafraid behavior
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Obsessive-Compulsive Disorder: Interventions

Anticipate needs, especially for information

Focus on client rather than on rituals
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Monitor nutrition/sleep; encourage meals/rest

Avoid hurrying client

Do not arbitrarily forbid rituals; give positive reinforcement
for non-ritualistic activity

Psychoeducation: medication, interrupting obsessive
thoughts
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Generalized Anxiety Disorder: Interventions

Stay with client

Speak slowly, using short and simple sentences

Assure client that nurse can assist him/her

Give brief explanations

Decrease stimuli

Administer anxiolytic if warranted

Encourage discussion of antecedent events

Encourage to link behavior to feelings

Teach cognitive therapy principles
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Generalized Anxiety Disorder: Interventions,
cont.

Question to clarify and dispute illogical thinking

Have client give alternative interpretations

Identify relief behaviors

Assist to reframe situation

Monitor own feelings
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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F
Post-Traumatic Stress Disorder: Interventions

Assess type of trauma, immediate action, and later coping

Assess pre-trauma functioning, including drug and ETOH
use

Assess post-trauma functioning, including drug and ETOH
use

Explore shattered assumptions

Promote discussion of possible meanings of event

Suggest that client not responsible for event, but is
responsible for coping

Identify social support and encourage use of support group
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
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