Psychological interventions

There are several factors that should be considered when providing psychosocial interventions for the client who suffers from anxiety. First, unless it is excessive anxiety is considered a natural part of life. If a client is diagnosed with a medical condition, some degree of anxiety is expected as well as beneficial in creating an discomfort that can help prepare the client for action or acceptance. Therefore, psychosocial interventions may be suggested but generally are not considered essential unless the anxiety is so pronounced that it affects occupational and social functioning. 

Second, when dealing with individuals who suffer from anxiety, the first course of action is to refer the client for a complete physical exam. The symptoms of anxiety are multifaceted (cognitive, behavioral, and somatic), and it is important that the client have a proper medical assessment to rule out physical causes for the anxiety or medical complications that may be caused by the disorder. 

although the social worker does not prescribe medications, an accurate medication history is needed to assist the prescriber in determining the need for medications and duration. This history should include prescribed medications, over-the-counter medications, and alternate therapies such as herbal preparations that may be used to control the anxiety (American Neuropsychiatric Association Committee on Research, 2000). 

Social workers should also screen the client with regard to any history of previous substance abuse. If substance abuse has occurred or is present, it may be more effective to recommend a medication like BuSpar that does not have the same addiction profile. 

Fourth, the social worker should also gather information on medications that the client is currently taking and explore whether any potential for substance abuse might occur. For example, the client may be using another stimulant such as caffeine and not realize the effect that it can have. 

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Hall SM, Reus VI, Munoz RF, et al Nortriptyline and cognitive-behavioral therapy in the treatment of cigarette smoking. Arch Gen Psychiatry 55 683-690, 1998 Hall SM, Humfleet GL, Reus VI, et al Psychological intervention and antidepressant treatment in smoking cessation. Arch Gen Psychiatry 59 930-936, 2002 Hayford KE, Patten CA, Rummans TA, et al Efficacy of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism. Br J Psychiatry 174 173-178, 1999... 

Psychogenic vomiting may benefit from psychological interventions. 

Four controlled, random-assignment studies comparing brief hospital treatment with relatively longer periods of hospital-based psychological intervention found that the brief hospital stays produced comparable results to the longer stay regimen (432, 433, 434, 435, 436 and 437). 

Clum, George A. 1989. "Psychological Interventions Versus Drugs in the Treatment of Panic." Behavior Therapy 20 429-57. 

The Role of Psychological Intervention in Modulating Aspects of Immune Function in Relation to Health and Well-Being... 

Alexander, D. A. (1990). Psychological intervention for victims and helpers after disasters. British Journal of General Practice, 40, 345-348. 

The treatment of major depressive disorder includes both pharmacological and psychological interventions. As to psychological treatments, cognitive and behavioral techniques have demonstrated positive results. Patients W ho respond to psychological intervention are usually in the range of mild to moderate symptom severity. 

As mentioned in chapter 2, individuals particular personality style and unique psychodynamics will often dramatically influence how they respond to pharmacotherapy. Robert Michaels (1992) has commented that in general clinical practice two-thirds of patients with Axis I disorders appear to respond quite well either to medication treatment or to brief, targeted psychological interventions, such as cognitive-behavioral or interpersonal therapy. However, a significant minority of patients with clear-cut Axis I disorders don t respond well to such treatments, primarily due to serious co-morbid character pathology. In treating these people, at the very least the clinician must be alert to how personality factors influence treatment outcome often medication treatment must be accompanied by more intensive psychotherapy that addresses the personality disorder. 

Behaviour-oriented psychological intervention is focused on interrupting the itching-scratching cycle training of alternative habits to scratching discrimination and control of scratching stimuli, and relaxation techniques. 

Discussion of diagnosis and treatment of food allergies and adequate nutrition in childhood behaviour-oriented psychological intervention to interrupt the itching-scratching cycle... 

Interpersonal psychotherapy (IP)—IP is a psychological intervention that focuses on interpersonal relationships and psychosocial functioning. 

Reid IC, Stewart CA. How antidepressants work. Br J Psychiatry 2001 178 299-303 Stimpson N, Agrawal N, Lewis G. Randomised controlled trials investigating pharmacological and psychological interventions for treatment-refractory depression. Br J Psychiatiy 2002 181 284-94... 

I Psychological interventions, educational change, medication and diet should all be available, and their use should be guided by an individualised treatment plan. 

For a particularly profound reaction, perhaps to the death of a child, formal psychological intervention may be valuable. 

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