Where do I go for treatment?

This is probably the first question people ask when considering who to see about their Anxiety Disorder. To a degree, the answer depends on how severely the person is affected by the disorder. Some people can experience a crisis where they feel that their life is completely out of control. They may also be very depressed or even suicidal. In these cases it is best to see a Mental Health Professional such as a Psychologist or Psychiatrist. For people not at the upper end of distress and/or disability, and this is the majority, it is more a matter of individual choice. 

Access to Treatment

Anxiety disorders respond very well to the use of Cognitive Behaviour Therapy (CBT). Currently, the major source of this treatment is through psychologists. Fortunately it is now easier and more affordable to access the services of psychologists.

A Medicare rebate is available to cover some of the cost of seeing a psychologist. You will need to ask what the gap will be and some psychologists may choose to bulk bill. You will need to see your GP to get a referral. The rebate will apply for up to 12 visits in a 12 month period. 

If you have private health insurance, your fund may provide some cover for seeing a psychologist. Check with your health provider.

You can also access services through the public health system at a community health centre or public hospital. However, there is usually a waiting list and it can take several weeks/months to see someone. 

An alternative to professional treatment is to learn some cognitive skills from a book about anxiety disorders (see Shop), by doing an anxiety management program and/or joining a support group. 

Psychiatrist

A Psychiatrist is a medical doctor who has also had many years additional training to become a Psychiatrist. As a doctor he can prescribe medication if necessary. The consultation fee is mostly covered by the Public Health System and usually the patient can negotiate any difference if they are experiencing financial hardship. For many people, the cost of treatment will be the deciding factor when choosing who to see. Some Psychiatrists specialise or have a special interest in Anxiety Disorders, but be aware these doctors are in demand and waiting lists can be quite long. You will also need to provide a referral from your General Practitioner. 

Therapy can take quite a while as the therapist and patient work together to isolate and work through the cause for anxiety and/or depression. By the time a person seeks treatment they are usually finding anxiety has become a considerable disruptive force in their lives. They will generally be looking for something which will provide relief in the short-term. As therapy is more a process of unfolding understanding, this type of treatment can cause the person to become impatient and they may not see the relevance or connection between what happens in therapy and their anxiety symptoms. Sometimes the things discussed in therapy can increase anxiety. The patient can feel as if they are getting worse not better, but this is part of therapy as the patient confronts the type of issues involved in their anxious condition. Of course another reason for anxiety to increase is that the therapy is not working or that the patient and therapist have not been able to establish a good relationship. In either case (providing every effort has been made), it is best to find another doctor.

These days some Psychiatrists are also trained Cognitive Therapists. This combination of therapies allows the patient to gain some practical skills for daily use, while also assisting them to gain insight into any underlying issues. 

Psychologist

Anxiety disorders respond very well to the use of Cognitive Behaviour Therapy (CBT) and, more recently, Acceptance Commitment Therapy (ACT). Most people will see a psychologist to access these therapies. Fortunately it is now easier and more affordable to do so.

A Medicare rebate is available to cover some of the cost of seeing a psychologist. You will need to ask what the gap will be and some psychologists may choose to bulk bill. You will need to see your GP to get a referral. The rebate will apply for up to 10 visits in a 12 month period.

If you have private health insurance, your fund may provide some cover for seeing a psychologist. Check with your health provider.

You can also access services through the public health system at a community health centre or public hospital. However, there is usually a waiting list and it can take several weeks/months to see someone.

There are several alternatives to professional treatment including:

• Workbooks with a focus on CBT or ACT
• Online therapy and self help ie. Anxiety Online (see links)
• Anxiety Management Workshops

Cognitive Behavioural Therapy (CBT)

CBT is one of the most common treatments provided by a Psychologist or Mental Health Professional.

It is recognised that when people feel highly anxious they think differently, and how they think affects how they behave.   An anxious person can become locked into a particular pattern of thinking which continuously generates negative and fear-based thoughts.

It is the recognition of the role thoughts play in anxiety and/or depression which underpins Cognitive Behaviour Therapy. The therapist helps the client to challenge negative or unrealistic thinking and where a client has been avoiding places or situations due to anxiety, CBT will assist them to overcome their fear through gradually exposing them to the feared situation.

Acceptance Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) is now commonly provided by a Psychologist or Mental Health Professional.

The aim of ACT is to maximise our potential for living a full and meaningful life by altering how we perceive and respond to uncomfortable thoughts and feelings. 

ACT teaches us psychological skills to deal with painful thoughts and feelings effectively - in such a way that they have much less impact and influence over us. 

Additionally, it helps us to clarify what is truly important and meaningful to us - ie our values - then use that knowledge to guide, inspire and motivate us to change our life for the better.

Hypnotherapy

Hypnotherapy is attractive because it appears to offer a cure with little or no effort on the part of the client. People who make good hypnotic subjects (and this is not everyone) may experience some relief in the short-term, but as the actual cause for the anxiety is not addressed, anxiety often reappears. Hypnotherapy is most useful if combined with Cognitive Behavioural Therapy, and some Psychologists are also trained hypnotherapists.

Graded Exposure

Some social workers, psychologists and counsellors will set up a program of Graded Exposure. This type of program is based on the theory that if a person is exposed to their feared situation gradually, they will eventually come to lose their fear. Graded Exposure alone does not take the thought process into consideration. It does not address the original cause for the fear. It does not provide any significant coping mechanisms to help the person deal with their symptoms and their fear of them. This is why a person may achieve their goal, but not feel any real sense of achievement. Graded Exposure is best applied as a component of cognitive behaviour therapy other facets of an anxiety disorder, not just the avoidant behaviour. 

Going it Alone

A lot of people choose not to get assistance, especially in the beginning. There are a whole range of reasons for this including the perceived stigmas associated with mental disorders, illnesses and professional treatment. However, just as you would carefully choose any other type of treatment, you need to be discerning about the self help you decide on. There is an amazing number of books available covering topics such as self esteem, stress, anxiety, depression, assertiveness, how to be happier and the list goes on……. Keep in mind that all books (and everything else including this website) is another person's view. It is up to you to test out the theories and research to see just how well they apply to your particular circumstances. As far as practical skills go, commit a reasonable amount of time to their learning and practice. If they don't work, make a mental note of why so you can learn something from the experience. 

The difficulty with self help is that you don't have anyone to bounce your questions off. You don't have anyone to say to you, "I know you think that, but maybe you should look at it another way…". Self help by its very nature is subjective and often you can't see the forest for the trees. It is difficult to see on your own that a particular way of thinking is flawed. Most people will try self help first, but will become frustrated or feel blocked from achieving the results they're looking for. It is important to recognise if or when you need call on the experts. This can be crucial in preventing the development of a full-blown Anxiety Disorder.