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Responding to the needs of a person experiencing Social Anxiety Disorder Monday 20 July 2020
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Responding to the needs of a person experiencing Social ... · • Joining a hobby or community group - e.g. quilting via meetup website. Helpful CBT manuals on social anxiety, perfectionism,

Sep 25, 2020

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Page 1: Responding to the needs of a person experiencing Social ... · • Joining a hobby or community group - e.g. quilting via meetup website. Helpful CBT manuals on social anxiety, perfectionism,

RespondingtotheneedsofapersonexperiencingSocialAnxietyDisorder

Monday20July2020

Page 2: Responding to the needs of a person experiencing Social ... · • Joining a hobby or community group - e.g. quilting via meetup website. Helpful CBT manuals on social anxiety, perfectionism,

Tonight’s panel

MsCatherineMadiganPsychologist

AssociateProfessorLisaLampePsychiatrist

DrCarolineJohnsonGeneralPractitioner

Facilitator:ProfessorStephenTrumble

GeneralPractitioner

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Learningoutcomes

Throughanexplorationofsocialanxietydisorderthewebinarwillprovideparticipantswiththeopportunityto:

• Identifyassociations,comorbiditiesandpatternsoftreatment-seekingbehaviourofpeopleexperiencingsocialanxietydisorder.

• Describetipsandstrategiesthatcanassistsomeoneexperiencingsocialanxietydisorder.

• Demonstratetheimportanceofcollaborationandappropriatereferralswhensupportingapersonexperiencingsocialanxietydisorder.

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The15minutehour

DrCarolineJohnsonGeneralPractitioner

• Engagingthepatient

• What’sthediagnosis?

• Isthepatientsafe?

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Theformulation

DrCarolineJohnsonGeneralPractitioner

• Presentingproblem(s)• Predisposingfactors• Precipitatingfactors• Perpetuatingfactors• Protectivefactors

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TheroleoftheMHTP

DrCarolineJohnsonGeneralPractitioner

• AMedicarecompliancetaskoratoolforengagementandrecovery?

Homework• Twotothreepersonaltreatmentgoals• Anoutcomemeasure• Someonlineresources• +/- a‘lifestory’

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Psychoeducation

DrCarolineJohnsonGeneralPractitioner

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eMental Health

DrCarolineJohnsonGeneralPractitioner

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DrCarolineJohnsonGeneralPractitioner

Item2712andbeyond

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Assessmentofsocialanxiety

MsCatherineMadiganPsychologist

• LeibowitzSocialAnxietyScale• DavidClark'squestionnaires,Safetybehaviours,Socialcognitions,Socialattitudes• Assesslevelofdepressione.g.BeckDepressionScale• Assessmentofalcoholintake• CheckforPerfectionismOCPD,OCD,GAD,BDD

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WorkwithclienttocomeupwithaCBTformulationofthemaintenanceoftheirsocialanxietydisorder

MsCatherineMadiganPsychologist

• Lookattheroleavoidanceandsafetybehavioursplayinmaintainingsocialanxiety• Lookattheroleselffocussedattentionplaysinmaintainingsocialanxiety- doattention

training• Lookattheroleofposteventprocessing(doingself-criticalpostmortemsafteraneventdoes

nothelp)• Stressthatimperfect isthenewperfect,it’soktomakemistakesandlet'sgooutandmake

them.

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Behavioralexperiments

MsCatherineMadiganPsychologist

• Forexample;gooutsidetheconsultingroomwiththeclient toshops,cafesetc.

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Theroleofsupportgroups

MsCatherineMadiganPsychologist

• InVictoriaADAVICandARCVICrunsupportgroups andevenhavesocialanxietyspecificgroups

• Perhapsalessthreateningplacetoabandonsafetybehaviours• Grouptherapymaybeanavailableoption• Joiningahobbyorcommunitygroup- e.g.quiltingviameetupwebsite

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HelpfulCBTmanualsonsocialanxiety,perfectionism,self-esteem,selfcompassion

MsCatherineMadiganPsychologist

• Clientsmayneedmedicationasverydepressed• Clientsmaypresentwithgoalsthatcannotbemetinashorttimeframee.g.imminentjob

intervieworspeechsoreferraltoGPforbetablockersmightbeappropriate

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Priority1– Diagnosticclarification

AssociateProfessorLisaLampePsychiatrist

Itisimportantto:• Developadiagnosticformulationtoguidetreatment• Identifycomorbidities• Notmissadisorderthatbetterexplainsthepresentingsymptoms

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AssociateProfessorLisaLampePsychiatrist

InthiscaseIwouldparticularlywanttobeclearabout:• Anxietysecondarytopersonalitystylee.g.obsessivecompulsive,avoidant• Majordepressionasprimaryorco-existingdisorder• Complextrauma• Alcoholuse

Priority1– Diagnosticclarification

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Priority2– Treatmentfocusedformulation

AssociateProfessorLisaLampePsychiatrist

Developingamodeltoexplain:1. Whysymptomsoccurredinthefirstplace

• Thiswillrequirehistorytosupportbiopsychosocialvulnerabilityfactors2. Whysymptomshavepersisted

• Cyclesofmaintenance/reinforcement• Cognitive,behavioural,interpersonalandenvironmentalreinforcers

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Priority3– Treatmentplanning

AssociateProfessorLisaLampePsychiatrist

• Shareformulationwithpatientandseekherinput• Providepsychoeducation:

• Anxiety,flight/fight• Socialanxietydisorder• Evidence-basedtreatmentoptions:CBT,pharmacotherapy

• Determinepatient’spreferredtreatmentapproach/es• Considerbarrierstotreatment

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Priority3– Treatmentplanningcontinued

AssociateProfessorLisaLampePsychiatrist

AssessmentandinitialmanagementAssesscomorbiddisorders,substanceuse,suicidalideation,psychosocialstressors,social/emotionalsupport.

Provideadviceonlifestyle(exercise,healthyeating,sleephygiene)AddresssubstanceabuseProvidepsychoeducation

Watchfulwaitingandreview

TreatmentplanningChooseinitialtreatmentincollaborationwiththepatient,withconsiderationofseverity,patientpreference,

previousresponsetotreatmentandavailability.Mobilizepsychosocialsupports

Continuedonnextslide

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Priority3– Treatmentplanningcontinued

AssociateProfessorLisaLampePsychiatrist

Initialtreatmentbasedonseverity

Mild

CBT

Moderate

CBTor

medicationor

CBTplusmedication

Severe

CBTplusmedication

Originalchartappearsin:RANZCPCPGsforpanic,SADandGAD.Andrews,G.,etal.(2018)."RoyalAustralianandNewZealandCollegeofPsychiatristsclinicalpracticeguidelinesforthetreatmentofpanicdisorder,socialanxietydisorderandgeneralisedanxietydisorder.“AustralianandNewZealandJournalofPsychiatry 52(12):1109-1172.

Initialtreatmentbasedonseverity

Mild

CBT

Moderate

CBTor

medicationor

CBTplusmedication

Severe

CBTplusmedication

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Q&A Session

MsCatherineMadiganPsychologist

AssociateProfessorLisaLampePsychiatrist

DrCarolineJohnsonGeneralPractitioner

Facilitator:ProfessorStephenTrumble

GeneralPractitioner

Page 22: Responding to the needs of a person experiencing Social ... · • Joining a hobby or community group - e.g. quilting via meetup website. Helpful CBT manuals on social anxiety, perfectionism,

Beforeyougo

Pleasecompletetheexitsurveybyclickingtheyellowicon

Upcomingwebinars

Inpartnershipwith31PrimaryHealthNetworks

Olderpersons,primarycareandmentalhealth- Wednesday22July

www.mhpn.org.au

Page 23: Responding to the needs of a person experiencing Social ... · • Joining a hobby or community group - e.g. quilting via meetup website. Helpful CBT manuals on social anxiety, perfectionism,

JoinanMHPNnetwork

Wouldyouliketocontinuethe‘SocialAnxietyDisorder’discussionwithlocalpractitioners?

Orperhapsstartdiscussingissuesoflocalrelevance?MHPNProjectOfficersareavailabletohelpyouestablishandsupportinterdisciplinarymentalhealthnetworksacrossmetropolitan,rural,regional

andremoteAustralia.

Wehave373networksaroundthecountry.Visitouronlinemaptofindoutwhichnetworksareclosetoyouatmhpn.org.auorcontactJacquiO’[email protected].

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Thankyouandgoodevening