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Clinical Services
 

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
 

Anthony, M.M., & McCabe, R.E. (2004). 10 Simple Solutions to Panic. Oakland, CA: New Harbinger Publications.

Barlow, D.H., & Craske, M.G. (2007). Mastery of your anxiety and panic, 4th ed. workbook). New York, NY: Oxford University Press.

Wilson, R. (2009). Don’t panic: Taking control of anxiety attacks, 3rd ed. New York, NY: HarperCollins.

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. (2004). 10 simple solutions to shyness: How to overcome shyness, social anxiety, and fear of public speaking. Oakland, CA: New Harbinger Publications.

Antony, M.M., & Swinson, R.P. (2008). The shyness and social anxiety workbook: Proven, step-by-step techniques for overcoming your fear, 2nd ed. Oakland, CA: New Harbinger Publications.

Butler, G. (2008). Overcoming social anxiety and shyness: A self-help guide using cognitive behavioral techniques. New York, NY: Basic Books.

Hope, D.A., Heimberg, R.G., Juster, H.R., & Turk, C.L. (2000). Managing social anxiety. New York, NY: Oxford University Press.

Monarth, H., & Kase, L. (2007). The confident speaker: Beat your nerves and communicate at your best in any situation. New York, NY: McGraw-Hill.

Stein, M.B., & Walker, J.R. (2009). Triumph over shyness: Conquering social anxiety disorder, 2nd ed. Silver Spring, MD: Anxiety Disorders Association of America.

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
 

Abramowitz, J.S. (2009). Getting over OCD: A 10-step workbook for taking back your life. New York, NY: Guilford Press.

Baer, L. (2000). Getting control: Overcoming your obsessions and compulsions, Revised Edition. New York, NY: Plume.

Carmin, C. (2009). Obsessive-compulsive disorder demystified: An essential guide for understanding and living with OCD. Cambridge, MA: Lifelong Books.

Foa, E.B., & Wilson, R. (2001). Stop obsessing! How to overcome your obsessions and compulsions, revised edition. New York, NY: Bantam Books.

Grayson, J. (2004). Freedom from obsessive-compulsive disorder: A personalized recovery program for living with uncertainty. New York, NY: Berkley Publishing Group.

Hyman, B.M., & Pedrick, C. (2005). The OCD workbook: Your guide to breaking free from obsessive-compulsive disorder (2nd edition). Oakland, CA: New Harbinger Publications.

Munford, P.R. (2004). Overcoming compulsive checking: Free your mind from OCD. Oakland, CA: New Harbinger Publications.

Munford, P.R. (2005). Overcoming compulsive washing: Free your mind from OCD. Oakland, CA: New Harbinger Publications.

Purdon, C., & Clark, D.A. (2005). Overcoming obsessive thoughts: How to gain control of your OCD. Oakland, CA: New Harbinger Publications.

Tolin, D., & Frost, R.O., Steketee, G. (2007). Buried in treasures: Help for compulsive acquiring, saving, and hoarding. New York, NY: Oxford University Press.

Tompkins, M.A., & Hartl, T.L. (2009). Digging out: helping your loved one manage clutter, hoarding, and compulsive acquiring. Oakland, CA: New Harbinger Publications.

Steketee, G., & Frost, R.O. (2007). Compulsive hoarding and acquiring (workbook). New York, NY: Oxford University Press.

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
 

Gyoerkoe, K.L., & Wiegartz, P.S. (2006). 10 simple solutions to worry: How to calm your mind, relax your body, & reclaim your life. Oakland, CA: New Harbinger Publications.

Hazlett-Stevens, H. (2005). Women who worry too much: How to stop worry and anxiety from ruining relationships, work, & fun. Oakland, CA: New Harbinger Publications.

Meares, K., & Freeston, M. (2008). Overcoming worry: A self-help guide using cognitive behavioral techniques. New York, NY: Basic Books.

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.

The ATRC is grateful to Martin M. Antony, Ph.D., ABPP for permission to use his compilations of reading recommendations.

Anxiety and Depression Comorbidity Program
 

Comorbidity Team Coordinator:

Susan Chudzik, M.Sc., C.Psych.Assoc.

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 Group for Clients with Panic, Social Anxiety, or Excessive Worry

The booster group is designed for clients who recently completed treatment at the Anxiety Treatment and Research Centre (ATRC) for Panic Disorder, Social Phobia, or Generalized Anxiety Disorder. The group occurs monthly.

The sessions are facilitated by Karen Rowa, Ph.D., C.Psych. For more information, please call Judy Odom at (905) 522-1155, ext. 33697.

 Goals

  • Prevent relapse

  • Address remaining symptoms

  • Help with continued exposure practice

  How we go About This

  • Reinforce Skills: We review and practice the skills learned during the treatment sessions. Members are encouraged to support each other and help one another problem solve. Members are also expected to set exposure-based homework each session and complete it between sessions.

  • Awareness of Risk Factors: We look at factors that contribute to the return of fear after treatment.

 

The booster group is held in F406 (on the fourth floor of the Fontbonne Building, St. Joseph’s Hospital) on WEDNESDAYS from 3:30 to 5 pm. 

The monthly schedule is as follows:

Wednesday January 27th, 2010

Wednesday February 24th, 2010

Wednesday March 31st, 2010

Wednesday April 28th, 2010

Wednesday May 26th, 2010

Wednesday June 30th, 2010

Wednesday September 29th, 2010

Wednesday October 27th, 2010

Wednesday November 24th, 2010

Wednesday December 29th, 2010

Booster Group for Clients with Obsessive-Compulsive Disorder 

    Information will be forthcoming regarding booster group services for OCD.  For a current update, please call Judy Odom at (905) 522-1155, ext. 33697.