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