Panic Disorder and Agoraphobia

This chapter addresses current understanding of panic disorder, with particular emphasis on assessment and treatment procedures. It first reviews the features of panic attacks and panic disorder, followed by a discussion of various theoretical perspectives on the problem, and assessment and treatment procedures, which focuses on pragmatics of working with clients with panic and agoraphobia.

Standards for Quality Care

This chapter discusses concrete steps for evaluating and improving quality of care. It first discusses ‘quality’ as a concept, reviewing indicators of good care at various levels of analysis, followed by recommendations for how to improve client outcomes at a local level, for instance, within a group practice. Finally, because suggestions for making improvements in patient care necessarily bring up the topic of changing practice patterns, some ways to learn new interventions and to influence one’s colleagues to make positive changes are explored.

Obsessive-Compulsive Disorder

This chapter presents a description of obsessive-compulsive disorder (OCD) and the prevailing theory of OCD. It also reviews assessment issues related to diagnosis and treatment planning, along with the role of triggers, cognitive appraisals, feared consequences, and avoidance in the occurrence of obsessive thoughts. The chapter will concentrate on the detailed application of behavioral and cognitive behavioral models of treatment for OCD, since these approaches have been guided by empirical development.

Specific Fears and Phobias

This chapter discusses specific fears and phobias, and provides an informational and theoretical base from which will be expanded into more complex anxiety disorders in later chapters. Specific phobias will be considered within a three-systems perspective, including behavioral, physiological, and cognitive components of the fear response. Unique features of some of the specific phobias will be discussed, and empirically supported treatment procedures will be described.

Posttraumatic Stress Disorder

This chapter outlines posttraumatic stress disorder (PTSD), its conceptualization (phenomenology, diagnostic trends, prevalence and course), theoretical perspectives, assessment (diagnosis, assessment of symptoms, and assessment of contextual factors), treatment models and guidelines (cognitive behavioral therapy (CBT) for PTSD, pharmacological treatment, eye-movement desensitization and reprocessing (EMDR), and client-treatment matching).

Social Phobia

This chapter first discusses the continuum of social anxiety, beginning with shyness, and reviews many of the complex issues associated with the psychopathology of social phobia, including cognitive features and behavioral manifestations of the disorder, as well as biological findings. Many new tools for assessing social phobia have been developed, and these will be discussed as they apply to clinical practice, including social skills training, exposure-based approaches, and cognitive techniques.

Evidence-Based Practice

Chapter 1 discusses evidence-based practice, including recent developments in the scientist-practitioner movement (treatments that work, efficacy, treatment guidelines, and managed care), scientific literature, the transfer of technology, measurement of client progress, the components of good guidelines and standards of proof.

Generalized Anxiety Disorder

This chapter discusses generalized anxiety disorder (GAD). This includes the phenomenology of GAD, and its prevalence, as well as theoretical perspectives on GAD (biological approaches, and psychological approaches), assessment, diagnostic criteria, and comorbidity. It discusses treatment models and guidelines (pharmacotherapy, psychological treatment, cognitive behavior therapy (CBT), and worry interventions), as well as treatment evaluation.

The Nature of Anxiety

This chapter explores the extent of current knowledge on the general nature of anxiety. It begins with a discussion of categorical and dimensional views of anxiety, including issues of diagnosis, subtyping, and comorbidity. It reviews research findings into the presence of a negative affect common to anxiety states, and cognitive factors that distinguish anxiety syndromes, as well as a hierarchical model of anxiety that incorporates information from both perspectives. Finally, results from research examining distinct components of the anxiety response (behavior, cognition, and physiology) are outlined.