Psychological interventions for anxiety in adult primary care patients: A review and recommendations for future research.
Journal of anxiety disorders
Anxiety symptoms are prevalent in primary care, yet treatment rates are low. The integration of behavioral health providers into primary care via the Primary Care Behavioral Health (PCBH) model offers a promising way to improve treatment options by adding a team member with the necessary skillset to deliver evidence-based psychological interventions for anxiety. We conducted a narrative review of psychological interventions for anxiety applied within adult primary care settings (k = 44) to update the literature and evaluate the fit of existing interventions with the PCBH model. The majority of studies were randomized controlled trials (RCTs; 70.5%). Most interventions utilized cognitive-behavioral therapy (68.2%) and were delivered individually, face-to-face (52.3%). Overall, 65.9% of interventions (58.6% of RCTs, 91.7% of pre-post) were effective in reducing anxiety symptoms, and 83.3% maintained the gains at follow-up. Although it is encouraging that most interventions significantly reduced anxiety, their longer formats (i.e., number and duration of sessions) and narrow symptom targets make translation into practice difficult. Methodological limitations of the research included homogenous samples, failure to report key procedural details, pre-post designs, and restrictive eligibility criteria. We offer recommendations to guide future research to improve the likelihood of successful translation of anxiety interventions into clinical practice.
- 1Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, United States; Department of Psychology, Syracuse University, Syracuse, NY, United States. Electronic address: Robyn.Shepardson@va.gov.
- 2Center for Integrated Healthcare, VA Western New York Healthcare System at Buffalo, Buffalo, NY, United States; Department of Psychology, University at Buffalo/State University of New York, Buffalo, NY, United States; Department of Psychology, University of Tampa, Tampa, FL, United States. Electronic address: email@example.com.
- 3VA Boston Healthcare System, Boston, MA, United States; Boston University School of Medicine, Boston, MA, United States; Alpert Medical School of Brown University, Providence, RI, United States. Electronic address: Risa.WeisbergHawkins@va.gov.
- 4Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, United States; Department of Psychology, Syracuse University, Syracuse, NY, United States; Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY, United States. Electronic address: Jennifer.Funderburk@va.gov.
Published by Elsevier Ltd.
Journal Article, Review
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||Last Modified: 2016-03-27