Chapter 14

Anxiety Disorders

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Mental health continuum for anxiety disorders

Slide 14-2 (Fig. 14-1)

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 PET scan: Obsessive-Compulsive Disorder

Slide 14-3 (Fig. 14-3)

From Lewis Baxter, MD, University of Alabama. Courtesy of the National Institutes of Mental
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Panic Disorder: Interventions
● Instruct to take slow, deep breaths
● Keep expectations minimal and simple
● Help connect feelings with attack onset
● Help client recognize symptoms as anxiety, not a
physical problem
● Identify therapies
● Teach abdominal breathing and positive self talk
● Psychoeducation: medication

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Phobia: Interventions
● Determine type of phobia and onset
● Have client list consequences of contacting feared
object
● Identify therapies for phobias
● Teach relaxation techniques
● Model unafraid behavior

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Obsessive-Compulsive Disorder:
Interventions
● Anticipate needs, especially for information
● Focus on client rather than on rituals
● Monitor nutrition/sleep; encourage meals/rest
● Avoid hurrying client
● Do not arbitrarily forbid rituals; give positive
reinforcement for non-ritualistic activity
● Psychoeducation: medication, interrupting obsessive
thoughts

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Generalized Anxiety Disorder:
Interventions
● Stay with client
● Speak slowly, using short and simple sentences
● Assure client that nurse can assist him/her
● Give brief explanations
● Decrease stimuli
● Administer anxiolytic if warranted
● Encourage discussion of antecedent events
● Encourage to link behavior to feelings
● Teach cognitive therapy principles

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Generalized Anxiety Disorder:
Interventions, cont.
● Question to clarify and dispute illogical thinking
● Have client give alternative interpretations
● Identify relief behaviors
● Assist to reframe situation
● Monitor own feelings

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Post-Traumatic Stress Disorder:
Interventions
● Assess type of trauma, immediate action, and later
coping
● Assess pre-trauma functioning, including drug and
ETOH use
● Assess post-trauma functioning, including drug and
ETOH use
● Explore shattered assumptions
● Promote discussion of possible meanings of event
● Suggest that client not responsible for event, but is
responsible for coping
● Identify social support and encourage use of support
group
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