| We offer comprehensive evaluations
and proven treatments for anxiety-related conditions. Treatments
at the ATRC include both medications and effective psychological
treatments. Our staff is available to consult with your family doctor,
psychiatrist and other professionals, who are involved in your care.
Evaluation Procedure
Every individual who is seen at the Anxiety
Treatment and Research Centre receives a comprehensive assessment.
This assessment may include:
- Detailed diagnostic interviews to
help clarify the diagnosis, to assess anxiety problems in particular,
and to examine psychological functioning.
- Psychiatric consultation to
provide further clarification of the problem and to help rule
out medical causes that may be contributing to your anxiety.
- Administration of questionnaires
to obtain additional information.
This thorough assessment is conducted because
anxiety-based disorders are complex and are often misdiagnosed.
The evaluation procedure helps us to determine the nature of the
problem. Based on these assessments, staff make appropriate recommendations,
which may include treatment at the Centre, by the referring doctor,
at another clinic or agency, or no treatment at all. Your doctor
will receive a report describing the results of the evaluation as
well as our recommendations for treatment.
Treatment Programs
The Anxiety Treatment and Research Centre
offers both medical and psychological treatments, as well as combinations
of these approaches. Medical treatments include various new and
established medications that have been shown to be useful for the
treatment of anxiety. Our psychological treatment programs are based
primarily on a form of treatment called cognitive-behaviour therapy
(CBT). CBT has been proven in numerous clinical trials to be an
effective method of reducing anxiety, fear and avoidance. In treatment,
the therapist and client work together to identify and change anxious
thoughts and behaviours that help to maintain a person’s anxiety
and related difficulties (e.g. avoidance of feared situations, compulsive
rituals).
In addition, when needed, other forms of psychological
treatment may be recommended, including family-assisted treatments
and supportive therapies. Psychological treatments are provided
both in group and individual formats, and typically last from 10
to 15 sessions. In addition, our program includes an ongoing monthly
“booster group” for individuals who have been through
one of our standard treatments and wish to obtain additional support
as they continue to use the strategies that they have learned during
their treatment. Finally, if further treatment is needed in the
future, our staff are available to provide additional consultation
for you or your doctor.
Treatment is short-term; we do not follow patients
over the long-term. When treatment is completed, patients are referred
back to their family doctor or to another professional if additional
treatment is required. Note that the ATRC offers a monthly booster
group for individuals who require occasional sessions to help maintain
the gains they made during treatment.
Panic Disorder Treatment
Program
The panic disorder treatment
program consists of both psychological and medication treatment
options. Psychological treatment involves cognitive behavioural
treatment (CBT), usually offered in a group format, allowing participants
to learn effective strategies for dealing with panic, along with
other individuals who are dealing with similar difficulties. Groups
typically have six to eight members and two therapists. Individual
CBT may also be an option depending on available resources. CBT
for panic disorder involves 10 to 12 weekly treatment sessions,
including the following components:
• Education about
the nature of anxiety and panic and the CBT model of panic;
• Cognitive strategies focused on shifting anxious thoughts
that trigger panic and maintain anxiety;
• Behavioural strategies aimed at reducing avoidance and safety
behaviours including gradual exposure to feared situations and physical
sensations;
• Weekly homework assignments to practice strategies learned
in treatment.
Medication options may be
offered through a consultation with a staff psychiatrist. In some
cases, CBT and medication are combined.
Treatment is short-term; we do not follow patients over the long-term.
When treatment is completed, patients are referred back to their
family doctor or to another professional if additional treatment
is required. Note that the ATRC offers a monthly booster group for
individuals who require occasional sessions to help maintain the
gains they made during treatment.
Recommended Readings
Craske, M.G., & Barlow, D.H. (2000). Mastery of your anxiety
and panic, third edition (MAP 3) (client workbook and client workbook
for agoraphobia). Boulder, CO: Graywind Publications, Inc.
Anthony, M.M., & McCabe, R.E. (2004).
10 Simple Solutions to Panic. Oakland, CA: New Harbinger Publications.
Zuercher-White, E. (1997).
An end to panic: Breakthrough techniques for overcoming panic
disorder, 2nd Edition. Oakland, CA: New Harbinger Publications.
Social Phobia Treatment
Program
The social phobia treatment
program consists of both psychological and medication treatment
options. Psychological treatment involves cognitive behavioural
treatment (CBT), usually offered in a group format, allowing participants
to learn effective strategies for dealing with social anxiety, along
with other individuals who are dealing with similar difficulties.
Groups typically have six to eight members and two therapists. Individual
CBT may also be an option depending on available resources. CBT
for social phobia involves 10 to 12 weekly treatment sessions, including
the following components:
• Education about
the nature of anxiety and the CBT model of social anxiety;
• Cognitive strategies focused on shifting anxious thoughts
that trigger anxiety;
• Behavioural strategies aimed at reducing avoidance and safety
behaviours including gradual exposure to feared situations, assertiveness
training, and social skills development;
• Simulated exposure or “role play” exercises
to practice strategies and further develop skills;
• Weekly homework assignments to practice strategies learned
in treatment.
Medication options may be
offered through a consultation with a staff psychiatrist. In some
cases, CBT and medication are combined.
Treatment is short-term; we do not follow patients over the long-term.
When treatment is completed, patients are referred back to their
family doctor or to another professional if additional treatment
is required. Note that the ATRC offers a monthly booster group for
individuals who require occasional sessions to help maintain the
gains they made during treatment.
Recommended Readings
Antony, M.M., & Swinson, R.P. (2000). The shyness and social
anxiety workbook: Proven, step-by-step techniques for overcoming
your fear. Oakland, CA: New Harbinger Publications.
Anthony, M.M. (2004).
10 Simple Solutions to Shyness. Oakland, CA: New Harbinger Publications.
Hope, D.A., Heimberg, R.G.,
Juster, H.R., & Turk, C.L. (2000). Managing social anxiety.
Boulder, CO: Graywind Publications, Inc.
Obsessive Compulsive
Disorder (OCD) Treatment Program
The OCD treatment program
consists of both psychological and medication treatment options.
Psychological treatment involves cognitive behavioural treatment
(CBT), usually offered in a group format, allowing participants to
learn effective strategies for dealing with OCD, along with other
individuals who are dealing with similar difficulties. Individual CBT
may also be an option depending on available resources.
Groups typically have four to six members and two therapists. CBT
for OCD involves 12 to 15 weekly treatment sessions, including the
following components:
• Education about
the nature of OCD and the CBT model of OCD;
• Gradual exposure to feared situations or triggers of obsessions;
• Learning strategies for preventing compulsions;
• Behavioural strategies aimed at reducing avoidance and safety
behaviours;
• Cognitive strategies for dealing with anxious thoughts;
• Weekly homework assignments to practice strategies learned
in treatment.
Medication options may be
offered through a consultation with a staff psychiatrist. In some
cases, CBT and medication are combined.
Treatment is short-term; we do not follow patients over the long-term.
When treatment is completed, patients are referred back to their
family doctor or to another professional if additional treatment
is required. Note that the ATRC offers a monthly booster group for
individuals who require occasional sessions to help maintain the
gains they made during treatment.
Recommended Readings
Foa, E.B. & Wilson, R. (2001). Stop obsessing! How to overcome
your obsessions and compulsions, revised edition. New York:
Bantam Books.
Hyman, B.M., & Pedrick,
C. (1999). The OCD workbook: Your guide to breaking free from
obsessive-compulsive disorder. Oakland, CA: New Harbinger Publications.
Generalized Anxiety
Disorder (GAD) Treatment Program
The GAD treatment program
consists of both psychological and medication treatment options.
Psychological treatment involves cognitive behavioural treatment
(CBT), usually offered in a group format, allowing participants to
learn effective strategies for dealing with GAD, along with other
individuals who are dealing with similar difficulties. Individual CBT
may also be an option depending on available resources.
Groups typically have four to six members and two therapists. CBT
for GAD involves 10 to 12 weekly treatment sessions, including the
following components:
• Education about
the nature of GAD and the CBT model of GAD;
• Progressive muscle relaxation aimed at reducing the physical
tension associated with chronic worry;
• Cognitive strategies aimed at reducing worries about potential
future situations / problems;
• Problem-solving strategies aimed at coping adaptively with
current situations;
• Behavioural strategies aimed at reducing avoidance,
reassurance-seeking and safety behaviours, including exposure
situations that arose uncertainly;
• Weekly homework assignments to practice strategies learned
in treatment.
Medication options may be
offered through a consultation with a staff psychiatrist. In some
cases, CBT and medication are combined.
Treatment is short-term; we do not follow patients over the long-term.
When treatment is completed, patients are referred back to their
family doctor or to another professional if additional treatment
is required. Note that the ATRC offers a monthly booster group for
individuals who require occasional sessions to help maintain the
gains they made during treatment.
Recommended Readings
Davis, M., Eshelman, E.R. & McKay, M. (2000). The relaxation
and stress reduction workbook, 5th Edition. Oakland, CA: New Harbinger Publications.
White, J. (1999).
Overcoming generalized anxiety disorder. Oakland, CA: New Harbinger Publications.
Bourne, E. & Garano, L (2003).
Coping with anxiety. Oakland, CA: New Harbinger Publications.
Treatment for Other Anxiety
Disorders
Depending on resources,
psychological treatment may be available for other types of anxiety
problems including specific phobias and posttraumatic stress disorder.
Cognitive behavior therapy (CBT) is provided either in individual
or group format. Medication options may be offered through a
consultation with a staff psychiatrist. In some cases, CBT and
medication are combined.
Anxiety and Depression
Comorbidity Program
Comorbidity Team Coordinator: Susan Chudzik,
M.S.
The term “comorbidity” refers to the co-occurrence of
two disorders. Research has found that there is a high comorbidity
rate with mood and anxiety disorders. Recent studies have found
up to 95% of patients diagnosed with a primary depressive illness
have been diagnosed with an anxiety disorder at some point in their
lifetime. These high prevalence rates are reflected in the patients
at Anxiety Treatment and Research Centre and the Mood Disorders
Program at St. Joseph’s Healthcare. Comorbidity is an issue
that is recognized at St. Joseph’s Healthcare. Training
opportunities exist for students interested in understanding the
reasons for overlap among anxiety and mood disorders and in treating
these problems.
The goal of the Comorbidity Service is to provide
a link between the Anxiety Treatment and Research Centre and the
Mood Disorders Program. The main objective of the service is to
provide care for patients with a comorbid diagnosis of a mood and
anxiety disorder. The Comorbidity service coordinates care in both
programs. It ensures that patients receive diagnostic clarification,
treatment recommendations, and/or coordination of cognitive behavioural
therapy services as needed. This service is available to patients
registered in either the Anxiety Treatment & Research Centre
or Mood Disorders Program. Patients cannot be directly referred
to the Comorbidity Service from their family physician. If required,
the service is offered after the patient has been assessed in the
Anxiety Treatment and Research Centre or Mood Disorders Program.
Booster Groups
The booster groups are designed for anxiety disorder patients who
have recently completed treatment at the Anxiety Treatment and
Research Centre (ATRC). These booster groups occur monthly
and are on a drop-in basis.
One booster group runs on the last Thursday of the month, and is
specifically geared towards individuals who have completed treatment
for OCD.
Michele Boivin, Ph.D., C.Psych (contact 905 522-1155 ext 35216) and
Andy Jacobs, Psy.D., C.Psych. (contact 905-522-1155 ext.32932) will facilitate the OCD booster group.
Another booster group runs on the last Wednesday of the month, and is
for individuals who have completed treatment for other disorders (PDA/SP/GAD).
Linda Cox, M.S.W. (contact 905 522-1155 ext 33824) and
an associate will facilitate the PDA/SP/GAD booster group.
Goals
- Relapse prevention
- Alleviation of residual symptoms
- Continued exposure practice
Description
- Reinforcement of Skills: the principles learned during the
treatment sessions will be reviewed and practiced. Group
members are encouraged to support and help one another by problem
solving for each other.
- Risk Factor Awareness: look at factors that contribute to the
return of fear after treatment termination.
Please take note that the PDA/SP/GAD booster group will be held in ROOM
F406 on WEDNESDAYSfrom 4:00 to
5:30 p.m. The monthly schedule is as follows:
Wednesday,
January 28, 2009
Wednesday,
February 25, 2009
Wednesday,
March 25, 2009
Wednesday,
April 29, 2009
Wednesday,
May 27, 2009
Wednesday,
June 24, 2009
NO GROUPS JULY AND AUGUST
Wednesday,
September 30, 2009
Wednesday,
October 28, 2009
Wednesday,
November 25, 2009
Wednesday,
December 16, 2009
Please take note that the OCD booster group will be held in ROOM
F406 on THURSDAYSfrom 4:00 to
5:30 p.m. The monthly schedule is as follows:
Thursday,
January 29, 2009
Thursday,
February 26, 2009
Thursday,
March 26, 2009
Thursday,
April 30, 2009
Thursday,
May 28, 2009
Thursday,
June 25, 2009
NO GROUPS JULY AND AUGUST
Thursday,
September 24, 2009
Thursday,
October 29, 2009
Thursday,
November 26, 2009
Thursday,
December 17, 2009
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