The Treatment of Anxiety Disorders: Clinician Guides and Patient Manuals

624 Pages·2002·5.92 MB·English

by  Gavin Andrews

TheTreatmentofAnxietyDisorders
ClinicianGuidesandPatientManuals
TheTreatmentofAnxietyDisordersbroughttogetherconciseyetthoroughtheoreticalreviews
withpracticalguidestotreatment.InthiscompletelyrevisedsecondeditionGavinAndrewsand
hisco-authorsreviewnewdevelopmentsintheresearchandtreatmentofanxietydisordersand
provideup-to-datetreatmentmaterials.Overhalfthematerialinthesecondeditionisnew,and
thereis anentirelynew section coveringposttraumatic stressdisorder. This is a uniqueand
authoritativeoverviewoftherecognitionandtreatmentofanxietydisorders,givingClinician
GuidesandPatientTreatmentManualsforeach.TheClinicianGuidesdescribehowtocreate
treatmentprograms,drawinguponmaterialsandmethodsthattheauthorshaveusedsuccess-
fullyinclinicalpracticefor15years.ThePatientTreatmentManualsprovidesession-by-session
resourcesforclinicianandpatienttoworkthrough,enablingeachpatienttobetterunderstand
andputintoeVectthestrategiesofcognitivebehaviortherapy.
Fromreviewsofthefirstedition:
‘‘Inmyopinionthisbookdeservesaplaceinanymedicallibraryforitsclearandcomprehensive
theoreticaloverview,anditssynthesisoftheoryandpracticeforalldoctorswhoseworkbrings
themintocontactwithanxiouspatients.’’
JournaloftheRoyalSocietyofMedicine
‘‘TheTreatmentofAnxietyDisordersisawell-referencedresourcebookandtreatmentguide.’’
ADAAReporter
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The Treatment of
Anxiety Disorders
Clinician Guides and Patient Manuals
Second Edition
GavinAndrews
ClinicalResearchUnitforAnxietyandDepression,
UniversityofNewSouthWalesatSt.Vincent’sHospital,Sydney
MarkCreamer
AustralianCentreforPosttraumaticMentalHealth(ACPMH),Melbourne
RoccoCrino
AnxietyDisordersClinic,St.Vincent’sHospital,Sydney
CarolineHunt
SchoolofPsychology,UniversityofSydney,Sydney
LisaLampe
ClinicalResearchUnitforAnxietyandDepression,
UniversityofNewSouthWalesatSt.Vincent’sHospital,Sydney
AndrewPage
SchoolofPsychology,UniversityofWesternAustralia,Perth
  
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo
Cambridge University Press
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Published in the United States of America by Cambridge University Press, New York
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© Cambridge University Press 2003
This book is in copyright. Subject to statutory exception and to the provision of
relevant collective licensing agreements, no reproduction of any part may take place
without the written permission of Cambridge University Press.
First published in print format 2002
- 
isbn-13 978-0-511-06704-4 eBook (NetLibrary)
- 
isbn-10 0-511-06704-6 eBook (NetLibrary)
- 
isbn-13 978-0-521-78877-9 paperback
- 
isbn-10 0-521-78877-3 paperback
Cambridge University Press has no responsibility for the persistence or accuracy of
s for external or third-party internet websites referred to in this book, and does not
guarantee that any content on such websites is, or will remain, accurate or appropriate.
Every effort has been made in preparing this book to provide accurate and up-to-date
information which is in accord with accepted standards and practice at the time of
publication. Nevertheless, the authors, editors and publishers can make no warranties
that the information contained herein is totally free from error, not least because
clinical standards are constantly changing through research and regulation. The authors,
editors and publisher therefore disclaim all liability for direct or consequential
damages resulting from the use of material contained in this book. Readers are strongly
advised to pay careful attention to information provided by the manufacturer of any
drugs or equipment that they plan to use.
Although case histories are drawn from actual cases, every effort has been made to
disguise the identities of the individuals involved.
Contents
Listofauthors vii
Prefacetothesecondedition ix
Abbreviations xi
1 Readme 1
2 Generalissuesinanxietydisorders 5
3 Generalissuesintreatment:ClinicianGuide 24
4 Panicdisorderandagoraphobia:Syndrome 36
5 Panicdisorderandagoraphobia:Treatment 54
6 Panicdisorderandagoraphobia:ClinicianGuide 65
7 Panicdisorderandagoraphobia:PatientTreatmentManual 84
8 Socialphobia:Syndrome 148
9 Socialphobia:Treatment 164
10 Socialphobia:ClinicianGuide 177
11 Socialphobia:PatientTreatmentManual 197
12 Specificphobias:Syndrome 261
13 Specificphobias:Treatment 271
14 Specificphobias:ClinicianGuide 277
15 Specificphobias:PatientTreatmentManual 287
16 Obsessive–compulsivedisorder:Syndrome 332
17 Obsessive–compulsivedisorder:Treatment 346
v
vi Contents
18 Obsessive–compulsivedisorder:ClinicianGuide 354
19 Obsessive–compulsivedisorder:PatientTreatmentManual 363
20 Generalizedanxietydisorder:Syndrome 383
21 Generalizedanxietydisorder:Treatment 398
22 Generalizedanxietydisorder:ClinicianGuide 407
23 Generalizedanxietydisorder:PatientTreatmentManual 417
24 Posttraumaticstressdisorder:Syndrome 465
25 Posttraumaticstressdisorder:Treatment 480
26 Posttraumaticstressdisorder:ClinicianGuide 492
27 Posttraumaticstressdisorder:PatientTreatmentManual 512
28 Conclusions 550
References 555
Index 604
List of authors
Gavin Andrews is Professor of Psychiatry in the School of Psychiatry at the University of
NewSouthWales,andDirectorof theClinicalResearchUnitforAnxietyandDepressionat
St.Vincent’sHospital,Sydney.
MarkCreamerisDirectorof theAustralianCentreforPosttraumaticMentalHealthanda
Professor in the Department of Psychiatry at the University of Melbourne. He is a clinical
psychologistwithmanyyearsofexperienceintheWeldoftraumaticstress.
RoccoCrinoisaclinicalpsychologistatSt.Vincent’sHospital.HeisDirectoroftheAnxiety
DisordersClinicandManagerofPsychologyatSt.Vincent’sHospital,Sydney.
Caroline Hunt is a clinical psychologist and Senior Lecturer in the School of Psychology,
UniversityofSydney.Sheisaclinicianwithmanyyearsofexperienceinthetreatmentofanxiety
disorders.
Lisa Lampe is a psychiatrist and Lecturer, School of Psychiatry, University of New South
Wales.SheisaclinicianwiththeClinicalResearchUnitforAnxietyandDepression,Sydney,
andDirector,AnxietyDisordersProgram,EveshamClinic,Cremorne,NewSouthWales.
AndrewPageisAssociateProfessorandDirectorofClinicalPsychology,SchoolofPsychol-
ogy,UniversityofWesternAustralia,Perth.
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Preface to the second edition
TheWrsteditionofthisbookwasdevelopedfromthePatientTreatmentManuals
thathadbeenusedintheClinicalResearchUnitforAnxietyandDepressionfor
thetreatmentofpatientswithanxietydisorders.Specializedtreatmentprograms
foranxietydisorderswereinitiatedin1978modeledonthetreatmentprogramfor
adultstuttererswithwhichDr.Andrewshadlongbeenassociated.JohnFranklin
designed and tested the Wrst program for patients with agoraphobia in 1979.
Since thenprograms for panic disorder and agoraphobia, social phobia, speciWc
phobias, generalized anxiety disorder, and obsessive–compulsive disorder have
beendevelopedandtested.Duringthese20years,manypeoplehavecontributed
to the redevelopment and testing of the Manuals for the various programs.
SigniWcantcontributionshavebeenmadebypreviousstaVmembersoftheunit,in
particular John Franklin, Paul Friend, Stephen MacMahon, Richard Mattick,
Carmen Moran, Conrad Newman, Susan Tanner, and Morison Tarrant. Robin
Harvey was the administrator of the Unit. Advice about the Wrst edition of this
bookwasforthcomingfromAlexBlaszczynski,AnetteJohansson,ColinMacLeod,
RichardMattick,HughMorgan,MichaelNicholas,CindyPage,RonRapee,Mark
Ryan, Derrick Silove, Michelle Singh, and Beth Spencer: their help is gratefully
acknowledged.
The second edition has been a much easier task. First, knowing that the Wrst
editionlackedacrediblesectiononposttraumaticstressdisorder,weinvitedMark
Creamer,theDirectoroftheAustralianCentreforPosttraumaticMentalHealth,
tocontribute.Second,havingtaught fromthe booktograduate studentsand to
practicing clinicians for some 7 years we had clear ideas about the changes that
were necessary. Third, the explosive growth in the literature in the past 7 years
meant that revising the chapters was exciting, rather than boring. Fourth, the
natural development of the treatment programs in the clinic meant that the
treatmentmanualsarethemselvesquitealteredandwearegratefulforadvicefrom
StephanieRosserandMerranLindsayonthismatter.Last,Dr.PageandDr.Hunt
nowworkinclinicsofotheruniversitiessotheircontributionscontainknowledge
fromthoseenvironments.Thusthe booknowcomesfrom theclinicsassociated
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