Treating Anxiety and Stress A Group

This book provides an introduction to Stress Control Method, a psycho-educational, didactic approach to therapy for anxiety and stress which has been developed and used extensively by the author and his colleagues.

Jim White is a consultant clinical psychologist in primary care working in Clydebank Health Centre

List of Figures

xi

List of Tables

xii

About the Author

xiii

Preface

xv

Part 1: The Argument for Change

1

(54)

Treating Anxiety: Delving beneath the Tip of the Iceberg

3

(17)

Introduction

3

(1)

Prevalence

3

(4)

Comorbidity

7

(4)

Anxiety at the Primary Care Level

11

(2)

Social Factors

13

(7)

Treating Anxiety: The Gulf between Research Findings and Clinical Realities

20

(18)

Research Centres and Routine Clinical Practice: Different Worlds?

20

(1)

Generalising from the Research Centre to the Clinic: The Pitfalls

21

(3)

Diagnostic Systems

24

(1)

The Issue of Comorbidity

25

(2)

Treatment Outcome: The Effect of Comorbidity

27

(1)

How Representative are Patients in Treatment Outcome Studies?

28

(2)

Specific versus Non-specific Factors

30

(5)

Time Considerations

35

(1)

Conclusions

35

(3)

Treating Anxiety: The Problems in Primary Care

38

(17)

Introduction

38

(1)

Mental Health and Primary Care

38

(3)

Developing a Primary Care Model

41

(1)

Dealing with Problems

41

(2)

Studies of Effectiveness in Primary Care: Heterogeneous Samples

43

(4)

Studies of Effectiveness in Primary Care: Anxiety Disorders

47

(3)

Anxiety Treatment as Part of an Interactive Service

50

(5)

PART 2: Issues in Devising and Setting-up the Group Therapy

55

(74)

The 'Stress Control' Method

57

(19)

Introduction

57

(1)

Stress Control

57

(2)

Providing a Rationale for the Approach

59

(5)

Diagnostic Issues

64

(5)

Therapy Issues

69

(7)

Setting up a Course

76

(14)

Introduction

76

(1)

Assessment Issues

76

(1)

The Assessment Interview

77

(1)

Introducing the Course

78

(4)

Questions

82

(4)

The Key Messages

86

(2)

Is an Assessment Interview Necessary?

88

(1)

Special Circumstances

89

(1)

Spouses/Partners/Friends

89

(1)

Conclusions

89

(1)

Developing Materials for the Course

90

(11)

The Importance of Written Material

90

(1)

Bibliotherapy

91

(2)

Stress Control

93

(1)

Therapist Manual

93

(1)

Self-help Manual

94

(6)

Conclusions

100

(1)

Preparing for the Course

101

(14)

The 'Stress Control' Components

101

(13)

Learning about Stress

101

(3)

Describing your Stress

104

(1)

Targeting your Stress

105

(1)

Daily Diary

106

(1)

Setting your Goals

106

(1)

Clearing the Decks

106

(7)

Quick Control

113

(1)

Conclusions

114

(1)

Running a Course

115

(14)

Introduction

115

(1)

Selecting the Venue

115

(1)

Setting up the Room

116

(1)

Pre-session

117

(2)

Group Size

119

(2)

Teaching Style

121

(2)

Teaching Aids

123

(1)

Session Format

124

(5)

PART 3: The Stress Management Course

129

(80)

Learning about Stress

131

(10)

Introduction and Information

131

(1)

Course Outline

132

(1)

Step 1 Revisited: Learning about Stress

132

(2)

The Session

134

(6)

Conclusions

140

(1)

Treating Somatic Anxiety

141

(10)

Step 8---Controlling your Body

141

(1)

Step 8: Controlling your Body

142

(1)

The Session

143

(6)

Conclusions

149

(2)

Treating Cognitive Anxiety

151

(12)

Step 9---Controlling your Thoughts

151

(1)

Step 9: Controlling your Thoughts

152

(2)

The Session

154

(8)

Conclusions

162

(1)

Treating Behavioural Anxiety

163

(12)

Step 10---Controlling your Actions

163

(1)

Step 10: Controlling your Actions

164

(1)

The Session

165

(9)

Conclusions

174

(1)

Treating Panic Attacks

175

(11)

Step 11---Controlling your Panic

175

(1)

Step 11: Controlling your Panic

176

(1)

The Session

177

(8)

Conclusions

185

(1)

Treating Insomnia

186

(6)

Step 12---Controlling your Sleep Problems

186

(1)

Step 12: Controlling your Sleep Problems

187

(1)

The Session

187

(5)

Treating Depression

192

(9)

Step 13---Controlling your Depression

192

(1)

Step 13: Controlling your Depression

193

(1)

The Session

193

(7)

Conclusions

200

(1)

Completing the Jigsaw

201

(8)

Step 14---Tying it all Together and Step 15: Controlling your Future

201

(1)

Steps 14 and 15: Tying it all Together and Controlling your Future

202

(5)

Conclusions

207

(2)

Part 4: Evaluation and Future Developments

209

(15)

Research Evidence

211

(13)

Evaluation

211

(1)

Controlled Evidence: The 1987 Study

211

(2)

Longer-term Follow-up

213

(2)

Recent Research

215

(3)

Comparison with Other Treatment Outcome Studies

218

(2)

`Stress Control' Run by Other Teachers

220

(1)

Developments

221

(1)

`Stress Control'

222

(1)

Conclusions and Summary

223

(1)

References

224

(19)

Index

243

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Treating Anxiety and Stress A Group Psycho-Educational Approach Using Brief CBT

Summary

Author Biography

Table of Contents

Supplemental Materials