101 Practical Strategies for the Treatment of GAD, Panic, OCD, Social Anxiety Disorder, Phobias and Insomnia

CPD

Handouts

Speaker

Jennifer L. Abel, PhD Related seminars and products

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Jennifer L. Abel, PhD, international speaker, author and clinical psychologist, has specialized in the treatment of anxiety disorders for over 20 years. Before opening a private practice, she served as the associate director of the Stress and Anxiety Disorders Institute at Penn State under the direction of the leading expert in Generalized Anxiety Disorder (GAD), T.D. Borkovec.

Her first book, Active Relaxation (Self-Published, 2010), has received outstanding reviews from mental health care professionals and anxious readers alike. Her second book, Resistant Anxiety, Worry, and Panic: 86 Practical Treatment Strategies for Clinicians (PESI, 2014), has received praise from top experts in anxiety management. Jennifer is also the author of The Anxiety, Worry & Depression Workbook: 65 Exercises, Worksheets & Tips to Improve Mood and Feel Better (PESI, 2018) and the Melt Worry and Relax Card Deck: 56 CBT & Mindfulness Strategies to Release Anxiety (PESI, 2016).

Dr. Abel has published many articles in professional journals and wrote a pamphlet about GAD for ABCT. She has been quoted by several popular magazines (e.g., Health, Prevention, Glamour) for her expertise in Worry. Dr. Abel presents to the public (e.g., Working Women’s Survival Show), as well as professionals (e.g., Australian Psychological Society; Anxiety Disorder Association of America).

 

Speaker Disclosures:
Financial: Jennifer Abel is in private practice. She receives royalties as a published author. Jennifer Abel receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Jennifer Abel has no relevant non-financial relationships.

Objectives

1. Identify the anxiety spiral in order to catch worry and panic early.
2. Outline alternatives to CBT when CBT is ineffective in the treatment of anxiety and insomnia.
3. Recognize 5 client habits that cause or contribute to anxiety including perfectionism, subjugation, procrastination, hypochondria, and catastrophizing and intolerance of uncertainty.
4. Discover how to use technology to treat anxiety, including audio recordings for relaxation, verbal exposure loops and video exposure.
5. Demonstrate progressive relaxation to treat tension headaches, fatigue, insomnia, chronic pain, muscle tension and high blood pressure.
6. Discuss the cycle of negative reinforcement and stop it by using the latest and most effective methods of exposure and response prevention.
7. List 4 unique mindfulness techniques to treat worry, OCD, panic and phobias, including mindful labeling and a mindfulness game.
8. Show how to use exposure therapy and mindfulness to treat obsessive compulsive disorder.
9. Explain when to use interoceptive and other exposures to treat panic attacks and when to utilize coping strategies.
10. Develop skills to treat all 3 aspects of social anxiety: skills deficits, irrational beliefs and physiological anxiety.
11. Use the most effective methods for treating agoraphobia and simple phobias, including flying phobia, emetophobia, acrophobia and claustrophobia.
12. Determine if sleep disorders or other medical problems interfere with sleep when trying to treat insomnia.
13. Identify at least 12 effective ways to treat insomnia without medication.

Outline

TREATMENT STRATEGIES FOR ANXIETY

Trying NOT to Worry Makes it Worse: The White Bear Research

• Treatments to circumvent the White Bear Phenomenon
  • Moving Toward relaxation
  • Process vs. command
  • Postpone worry
  • Acceptance

Mindfulness

• Mindful acceptance:
  • 5 metaphors
  • Observe and label thoughts and emotions
• Mindfulness as relaxation
  • Being in the present
  • Active and quiet mindfulness
  • Game and demonstrations

Cognitive Therapy

• A quicker and better way – B3s
• Hands-on exercises to find alternative thoughts
• “Shoulds” and “Wants”
• Finding humor in worry

Progressive Relaxation (PR)

• 8 benefits of PR
• Signaling and timing
• Patter
• Debriefing and home practice instructions
• Alternatives to PR -Tin Man to Scarecrow and sponge absorbing tension

Problem Solving Strategies

• Worry prevents problems solving
• Mindfully label problems
• Brainstorming
• Postpone worry to problem solving times
• Problem solving worksheet

Exposure Strategies

• Negative reinforcement in anxiety
• Metaphor – Little Shop of Horrors
• Assess for negative reinforcement
• Remove crutches that negatively reinforce
• Traditional in vivo exposure
• Imaginal exposure
• Video exposure
• Flooding the thoughts and words
• Interoceptive exposure
• Response prevention

Make Your Own Recordings:

• Record for free
• Turn recordings into MP3s
• Make loops for verbal exposure
• Make relaxation recordings
• Transport large MP3s to clients for free

SPECIFIC PROGRAMS FOR ANXIETY DISORDERS AND INSOMNIA

Generalized Anxiety Disorder

• Worry spirals
• 3 benefits of catching anxiety early and evidence this works.
• 12 reminders to catch anxiety early
• Self-controlled desensitization (SCD)
• Applied or active relaxation

OCD

• In vivo exposure and response prevention
• Alternative exposures
• Covert obsessions (normalizing, flooding thoughts and singing words)
• Contamination fears
• Mindfulness and OCD

Panic Disorder and Panic Attacks

• New panic attack specifier
• Interoceptive exposure
• Explain what caused that first panic attack
• Anxiety sensitivity
• When panic looks like OCD
• Anxiety spiral in panic
• Benzodiazepenes make panic worse
• Nighttime panic

Agoraphobia and Specific Phobia

• Rule out fear of panic
• Exposures:
  • In vivo
  • Imaginal
  • Flood the fear verbally
  • YouTube and other Internet options
• Three Common Specific Phobias - flying, emetophobia, acrophobia

Social Anxiety

• 3 components of social anxiety: skills deficit, cognitive distortions, physiological anxiety
• Normalize social anxiety
• Social skills training - eye contact, open ended questions, listening, improving affect
• Exposure: in vivo, role play, flooding thoughts
• Coping strategies
• Speech phobia

Insomnia

• Rule out other sleep disorders and medical causes
• Treatments for insomnia:
  • Worry postponement and problem solving before bed
  • Sleep hygiene and several stimulus control strategies
  • Creating a sleep rhythm by addressing schedules, naps and lighting
  • The win-win trick
  • Relaxation strategies

TREATMENT RESISTANT ANXIETY

When CBT isn’t Effective Enough

• Rule out ADHD, depression and medical issues
• Encourage emotional processing
• Address lifestyle habits
• Psychotropic medications
• When CBT and medication doesn’t work:
  • Increase emotional processing
  • Experiential techniques
  • Address interpersonal problems shown to interfere with CBT

Personality Traits Associated with Anxiety and What To Do:

• Hypochondriasis and fear of untimely death - postponing, flooding, etc.
• Perfectionism - strategies for balance and better life
• Subjugation - continue “the wants” stop negatively reinforcing fear and guilt
• Catastrophizing/intolerance of uncertainty - postpone, address superstitions and worry
• Procrastination - planned procrastination and creating small goals.

Target Audience

Reviews