Evaluation of Treatment Approaches in Clinical Psychology

For this Assignment, pretend that you are applying for a position as a clinical psychologist. You have already submitted your resume and application, and have now been moved to the next stage of the interview process! This round requires a research paper providing evidence of your knowledge of mental health and different treatment approaches.

Select a psychological disorder from the DSM-5 that you are likely to deal with in your chosen career. Using the proper APA formatting guidelines, please write a 6-10 page report that specifically addresses all of the following:

Name of this disorder (Generalized Anxiety Disorder)

Symptoms of this disorder.

Number of people or percentage of the population diagnosed with this disorder each year.

Suspected causes of this disorder.

Write a paragraph for each of the four major schools of psychotherapy (Psychodynamic, Humanistic, Behavioral, and Cognitive). How would each of these different schools of thought approach the treatment of this disorder?

Which therapeutic approach do you think is best for this problem? Why?

What kind of resistance would you expect in treating this kind of problem?

How might the Prochaska Model of Change assist with your treatment efforts?
What motivational interviewing strategies might be applied to the treatment of this disorder? Explain.

How might manualized approaches to therapy help or hinder your treatment efforts? Explain.

Discuss any dual diagnosis issues that are likely with this diagnosis. Please include at least one source external to the text to support your conclusions regarding possible dual diagnosis.

Generalized Anxiety Disorder

Name of the student

Affiliation

Course

Instructor’s name

Submission date

Generalized Anxiety Disorder

Introduction

Psychological disorders are behavioral and mental patterns that result in distress and impairment of an individual. This research focuses on generalized anxiety disorder, a disorder characterized by insistently and excessively repetitive worry about things in an individual’s life. Patients suffering from this disorder feel anxious, especially if their experience is stressful, and prolonged anxiety may become difficult to control, interfering with an individual’s daily life and activities. GAD affects about 6.8 million people, equivalent to 3.1% of the USA adult population. When comparing men and women, women are affected more, and only 43.6% of people receive treatment (Mayo, 2017). Below are a comprehensive discussion and detailed research on the manifestation, prognosis, diagnosis, and treatment of GAD.

Manifestation and Prognosis 

Symptoms of GAD are similar to other anxiety and depression disorders such as panic, obsessive-compulsive, and PSTD, among others; however, they are different conditions and disorders. Notable symptoms of GAD include persistent worry or anxiety in an individual, especially on the impacts of events, overthink worst-case scenarios, perceive events as threatening, and find it difficult to handle uncertainties in life. Moreover, patients suffering from GAD find it difficult to relinquish worry; they cannot relax or concentrate, as they are overwhelmed, restless, and always concerned about impacts and event outcomes (Mayo, 2017). Physically, GAD patients experience fatigue, tense and painful muscles, constant nervousness, irritability, trembling, and have trouble sleeping. GAD patients experience extreme worry and intense anxiety levels as they worry about their safety, families, and general life. In research conducted, GAD are the most prevalent and common causal factors of workplace disability. These symptoms among adults commence at 31 years, and they gradually occur or appear. GAD among children and teenagers are similar to those in adults as they include excessive worries on safety, punctuality, natural disasters, and academic performance (Mayo, 2017). They suffer from anxiety, the need for perfectionism, reduced confidence, and a dire need for approval. Symptoms here range from early childhood to middle ages.

GAD are multi-determined as complex factors ranging from biological, individual, social, physical, and environmental factors interact to cause the disorder. Biologically, GAD can result from genetic makeup in the family, as well as variations of brain chemistry and its functions among people (Mayo, 2017). Socially, how people perceive and react to threats and their interaction matters, as they determine the degree of anxiety and worry felt. Individually, development and personality variations are causal factors, as they determine levels of anxiety and fear as well.

Diagnosis and Treatment

The treatment of GAD requires a comprehensive diagnosis and implementation of diverse treatment plans. In the diagnosis of GAD, physicians conduct physical exams, blood or urine tests, use psychological therapy, and follow the DSM-5 criteria to identify underlying medical conditions and symptoms. Psychotherapy schools of thought have diverse thoughts and approaches in the treatment of GAD. Behavioral perspective focuses on learning how environmental factors acting stimuli affect the observable behavior of a GAD patient. This approach argues that people learn from their environments through classical and operant conditioning; hence, the behavioral therapy can be used to relax and create positive emotions among patients. Through behavioral therapy, GAD patients are taught to rest their feelings on what they see hence balancing their moods (Borza, 2017). The cognitive perspective focuses on patient thoughts, stating that cognitive therapists believe dysfunctional thinking results in dysfunctional behaviors. Thus, through cognitive therapy, GAD patients can be helped to isolate these dysfunctional thoughts and disjoint them from excessive anxiety and worry.

The psychodynamic perspective focuses on exploring a GAD patient’s past life and experiences to identify possibilities of having developed the disorder and effective mitigation solutions. Psychodynamic therapists argue that treating a patient suffering from GAD requires exploring and focusing on their external world. They describe their childhood experiences, fantasies, current fears, desires, and dreams, among others, to determine sources of negative emotions, helping them understand, and resolve these repressed emotions. The humanistic approach contends that a human being is seen as a whole and has the inherent potential to effect self-change. Hence, humanistic therapy seeks to help people achieve their potential, uniqueness, and subjectivity to become more self-aware, accept themselves, understand their feelings, and through free will, make the decision to control and manage their thoughts and emotions.

The most effective therapeutic approach would be a CBT (Cognitive-behavioral therapy) treatment as it addresses mental, social, individual, and environmental causal factors of GAD. Therefore, it is conclusive and comprehensive, as it addresses some of the most critical sources of worry and excessive anxiety in a human’s life. Moreover, the approach is easy, quick, and helps a patient cope with specific challenges experienced. When left untreated, GAD can be highly comorbid and result in chronicity with excessive anxiety. As per statistics, only 43% of the patients are treated. Among these, possible resistance expected includes complete refusal to acquire treatment, non-response to first-line treatment strategies, adverse drug-drug interactions among patients with comorbid illnesses, and metabolic alterations (Dilbaz, Cavus, & Darcin, 2011). First-line interventions include medication and psychological therapies such as CBT. When these treatments are not personalized depending on a patient’s age, comorbidities, and other medication histories, treatment resistance is expected.

The refusal or resistance of GAD patients to seek and maintain treatment requires intervention, which through the six stages of change as described by Prochaska, can help change radicalized thoughts and behaviors. The first stage of refusing treatment is defined as pre-contemplation, where GAD patients feel their excessive worry, and uncontrolled anxiety is unproblematic and does not produce any adverse effects. With time, they begin contemplating on their behavior, which is the right moment to introduce treatments such as CBT, hence, acting as a motivational strategy to induce and maintain effective treatment. In the preparation stage, GAD patients are ready to change through behavioral change, which would result in taking action. At this stage, treatment should be comprehensive and conclusive. In the maintenance stage, their excessive worries are changed, where they maintain the changed behavior. Finally, the desire to remain healthy and eliminate unhealthy behavior is reached.

Manualized therapy approaches help rather than hinders GAD patient’s progress as they have well outlined and prescribed goals and methods to be incorporated in every therapy session. Moreover, they are empirically supported treatments, which utterly can assist in EBP and research on psychological therapies to make them efficient and more effective. Finally, manual approaches are conclusive as they can apply in a wide variety of psychological disorders ranging from anxiety to depression, chronic stress, and PSTD, among others. A dual diagnosis issue that may arise from people with GAD would be substance use. Research shows that extreme anxiety among people displaying GAD symptoms is associated with substance dependence. They are intertwined, as patients are dependent on these drugs to maintain comorbidities and excessive worry (Christiansen, 2020). An anxious person is overly alert, have negative thoughts or emotions that may result in alcohol or drug dependence to ease or reduce these feelings and symptoms.

References

Borza, L. (2017). Cognitive-behavioral therapy for generalized anxiety. Dialogues Clinical Neuroscience, Vol 19(2), pp; 203-208.

Christiansen, T. (2020, January 28). Generalized Anxiety Disorder and Substance Abuse. Retrieved from https://www.therecoveryvillage.com/mental-health/generalized-anxiety-disorder/substance-abuse/

Dilbaz, N., Cavus, S. Y., & Darcin, A. E. (2011). Treatment Resistant Generalized Anxiety Disorder. In Different Views of Anxiety Disorders. Open Access book.

Mayo, C. (2017, October 13). Generalized anxiety disorder. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803

Sarris, J. C. (2013). Kava for the Treatment of Generalized Anxiety Disorder RCT: Analysis of Adverse Reactions, Liver Function, Addiction, and Sexual Effects. Phytotherapy Research, Vol 27(11).