While research concerning both psychological and pharmacological treatments for co-occurring anxiety and AOD use disorders is sparse [1172, 1221], there is increasingly promising evidence for integrated treatments that target both disorders [669, 1169, 1171, 1222]. In the absence of research examining treatments for co-occurring anxiety and AOD use disorders, it may be useful to seek guidance from treatment approaches to single disorders. More rigorous research is required in order to determine whether the same approach for treating single disorders is equally efficacious in the treatment of co-occurring disorders.
Box 18 illustrates the continuation of case study E, following Declan’s story after his heart attack.
Box 18: Case study E: Treating co-occurring anxiety and AOD use: Declan’s story continued
Case study E: Declan ’s story continued
Declan started seeing a psychologist at his local AOD service, who diagnosed him with social phobia with panic attacks. Declan also started seeing a cardiologist. A treatment plan was developed in consultation with Declan, and his psychologist suggested that they try CBT for the treatment of his anxiety and AOD use. In addition to CBT, Declan started using a mindfulness app, which he found annoying at first, but after a few weeks started to incorporate into his physical fitness routine and started to find more beneficial.
Declan’s CBT helped him understand the reasons for his panic and fear. His psychologist also organised for Declan to attend weekly sessions of a local relapse prevention program run by their AOD service. His psychologist helped him address avoidance behaviours with a program of gradual exposure to situations that he had previously found anxiety provoking. While Declan continued to respond well to treatment, he and his psychologist agreed that he should remain in contact with the psychologist over the long-term, but the frequency of sessions gradually reduced over time.
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Key Points
- Treatments for anxiety and AOD use may require client contact over a period of months, rather than weeks.
- Without addressing AOD use, psychological treatments for anxiety may be rendered ineffective.
- The use of apps or other e-health interventions can be a useful adjunct to psychotherapy.