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SJHH ... / Health Services/ Mental Health & Addiction Services/ Mental Health Services/ Anxiety Treatment and Research Clinic (ATRC)/ Anxiety Treatment Program: By Diagnosis

Anxiety Treatment Program: By Diagnosis

The following Treatment Programs are available through the Anxiety Treatment and Research Clinic:

Anxiety, Depression, and Women's Health Comorbidity Program

Complex Diagnosis Service

Consultation Services for Children & Adolescents with Probable Obsessive-Compulsive Disorder

Generalized Anxiety Disorder (GAD) Treatment Program

Obsessive Compulsive Disorder (OCD) Treatment Program

Panic Disorder Treatment Program

Social Anxiety Disorder Treatment Program

Posttraumatic Stress Disorder Treatment Program

Treatment for Other Anxiety Disorders
 

Anxiety, Depression, and Women's Health Comorbidity Program

The goal of the Comorbidity Service is to provide a link between the Anxiety Treatment and Research Clinic, the Mood Disorders Program and the Women's Health Concerns Clinic. The main objective of the service is to coordinate care for patients who may benefit from service from two or three of these clinics.

This service is available to patients registered in either the ATRC, Women’s Health Concerns Clinic, or Mood Disorders Program.  Patients cannot be directly referred to the Comorbidity Service from their family physician. If required, the service is offered after the patient has been assessed at the ATRC, Women’s Health Concerns Clinic, or Mood Disorders Program.

Complex Diagnosis Service

The Complex Diagnosis Service is offered to patients referred to ATRC with anxiety symptoms who have significant co-existing psychiatric disorders. These coexisting conditions may be the basis for the anxiety presentation or be contributing to it. 

Patients will receive a comprehensive psychiatric evaluation. Psychological, Occupational Therapy, Social Work and Nursing Consultations are available if needed. 

Recommendations will be made to the referring physician regarding pharmacological and psychological treatments. Information on appropriate resources will be provided to the patient.

Consultation Services for Children & Adolescents with Probable Obsessive-Compulsive Disorder

The Anxiety Treatment and Research Clinic at St. Joseph’s Healthcare Hamilton is pleased to offer, on a non-urgent basis, a consultation service for children and adolescents between the age of 6 to 17 years with a probable diagnosis of Obsessive Compulsive Disorder (OCD).  The consultation service provides the following:

  1. For youth residing within the Hamilton catchment area: Consultation on a non-urgent basis for diagnostic assessment and clarification, treatment recommendations and medication consultation. The consultation includes an extensive psychoeducational component.  Following the consultation, we may recommend a collaborative OCD intervention with Chedoke’s Child & Youth Mental Health Services.
  2. For youth residing outside of the Hamilton catchment area: Consultation on a non-urgent basis for diagnostic assessment and clarification, treatment recommendations, and medication consultation.

Referrals to the Pediatric OCD Consultation Service must be made through a family physician.  Click here to download and print the referral form.  Once completed by a family physician, the referral can be faxed to Amber Elcock at 905-521-6120.

For a list of recommended readings/self-help books for parents, children and adolescents, click here.

A Family Education Series on Obsessive-Compulsive Disorder in Children and Adolescents is offered quarterly:  The ABC's on OCD 

 

Generalized Anxiety Disorder (GAD) Treatment Program

The GAD Treatment Program consists of both psychological and medication treatment options. Psychological treatment involves Cognitive Behavioural Therapy (CBT) offered in a group format, allowing participants to learn effective strategies for dealing with GAD.  CBT for GAD involves 12 weekly sessions including the following components:

  • Education about the nature of GAD
  • Relaxation strategies aimed at reducing the physical tension associated with chronic worry
  • Cognitive strategies aimed at reducing worries about potential future situations/problems
  • Problem-solving strategies aimed at coping adaptively with current situations
  • Behavioural strategies aimed at reducing avoidance, reassurance-seeking and safety behaviours
  • Weekly homework assignments to practice strategies learned in treatment

For a more detailed general description of CBT principles and components, please click here

Medication options may be offered through a consultation with a staff psychiatrist. In some cases, CBT and medication are combined.  Treatment is short-term; we do not follow patients over the long-term. When treatment is completed, patients are referred back to their family doctor or to another professional if additional treatment is required. Note that the ATRC offers a monthly booster group for individuals who require occasional sessions to help maintain the gains they made during treatment.

For a list of recommended readings/self help books for people with generalized anxiety disorder, click here.

Obsessive Compulsive Disorder (OCD) Treatment Program

The OCD Treatment Program consists of both psychological and medication treatment options. Psychological treatment involves Cognitive Behavioural Therapy (CBT), offered in a group format, allowing participants to learn effective strategies for dealing with OCD. Individual CBT may also be an option depending on available resources.  CBT groups for OCD involve 12 weekly sessions and include the following components:

  • Education about the nature of OCD
  • Gradual exposure to feared situations or triggers of obsessions
  • Learning strategies for preventing compulsions
  • Behavioral strategies aimed at reducing avoidance and safety behaviours
  • Cognitive strategies for dealing with obsessions
  • Weekly homework assignments to practice strategies learned in treatment

For a more detailed general description of CBT principles and components, please click here

For individuals who continue to have residual symptoms after completing CBT, there are options to receive Mindfulness-Based CBT for OCD.  This is an 8 session group being offered in the context of a research study.  Treatment includes learning mindfulness strategies and how these might help people react differently to their OCD symptoms.

Medication options may be offered through a consultation with a staff psychiatrist. In some cases, CBT and medication are combined. Treatment is short-term; we do not follow patients over the long-term. When treatment is completed, patients are referred back to their family doctor or to another professional if additional treatment is required. Note that the ATRC offers a monthly booster group for individuals who require support to help maintain the gains they made during treatment.

For a list of recommended readings/self-help books for people with obsessive-compulsive disorder, click here.

Panic Disorder Treatment Program

The Panic Disorder Treatment Program consists of both psychological and medication treatment options for both panic disorder with or without agoraphobia. Psychological treatment involves cognitive behavioural therapy (CBT), offered in a group format, allowing participants to learn effective strategies for dealing with panic. CBT for panic disorder involves 12 weekly treatment sessions, including the following components:

  • Education about the nature of anxiety and panic and the CBT model of panic
  • Cognitive strategies focused on shifting anxious thoughts that trigger panic and maintain anxiety
  • Behavioural strategies aimed at reducing avoidance and safety behaviours including gradual exposure to feared situations and physical sensations
  • Weekly homework assignments to practice strategies learned in treatment

For a more detailed general description of CBT principles and components, please click here

Medication options may be offered through a consultation with a staff psychiatrist. In some cases, CBT and medication are combined. Treatment is time limited; we do not follow patients over the long-term. When treatment is completed, patients are referred back to their family doctor or to another professional if additional treatment is required.

Note that the ATRC offers a monthly booster group for individuals who require support to help maintain the gains they made during treatment.

For a list of recommended readings/self-help books for people with panic disorder, click here.

Social Anxiety Disorder Treatment Program

The Social Anxiety Disorder Treatment Program consists of both psychological and medication treatment options. Psychological treatment involves cognitive behavioural therapy (CBT) offered in a group format, allowing participants to learn effective strategies for dealing with social anxiety.  CBT for social phobia involves 12 weekly treatment sessions, including the following components:

  • Education about the nature of anxiety and the CBT model of social anxiety
  • Cognitive strategies focused on shifting anxious thoughts that trigger anxiety
  • Behavioural strategies aimed at reducing avoidance and safety behaviours including gradual exposure to feared situations, assertiveness training, and social skills practice
  • Weekly homework assignments to practice strategies learned in treatment

For a more detailed general description of CBT principles and components, please click here.  

Medication options may be offered through a consultation with a staff psychiatrist. In some cases, CBT and medication are combined. Treatment is short-term; we do not follow patients over the long-term. When treatment is completed, patients are referred back to their family doctor or to another professional if additional treatment is required.

Note that the ATRC offers a monthly booster group for individuals who require support to help maintain the gains they made during treatment. 

For a list of recommended readings/self-help books for people with social anxiety disorder, click here.

Posttraumatic Stress Disorder Treatment Program

The Posttraumatic Stress Disorder (PTSD) Treatment Program consists of both psychological and medication treatment options.  Psychological treatment involves a particular kind of cognitive behavioural therapy (CBT), known as cognitive processing therapy (CPT), offered in a group format, allowing participants to learn effective strategies for dealing with PTSD.  CPT for PTSD involves 12 weekly treatment sessions, including the following components:

  • Education about PTSD symptoms
  • Education about common emotional reactions and changes in beliefs about oneself, others, and the world, after a traumatic event
  • Writing about your beliefs associated with the trauma and its impact
  • At home practice assignments that include completing readings and worksheets that challenges your thoughts about the trauma, so that they become more balanced and less distressing
  • Challenging problematic beliefs concerning issues such as how safe one really is in the world, trusting oneself and others, how much power/control we have over life events, self-esteem, and intimacy.

Medication options may be offered through a consultation with a staff psychiatrist.  In some cases, CPT and medication are combined. 

Treatment for Other Anxiety Disorders

Depending on resources, psychological treatment may be available for other types of anxiety problems including specific phobias and anxiety about physical illness. Cognitive Behavior Therapy (CBT) is provided in group format. Medication options may be offered through a consultation with a staff psychiatrist. In some cases, CBT and medication are combined.

Booster Groups
The Anxiety Treatment and Research Clinic offers short-term assessment and treatment. To complement this therapy and provide ongoing support, we are pleased to provide the following Booster Groups.

Booster Group: Panic, Social Anxiety, or Excessive Worry
This Booster Group is designed for clients who recently completed treatment at the Anxiety Treatment and Research Clinic (ATRC) for Panic Disorder, Social Phobia, or Generalized Anxiety Disorder. The group occurs monthly and is on a drop-in basis. 

Goals:

  1. Provide support
  2. Address remaining symptoms
  3. Help with continued exposure practice

For more information, please call Lisa Di Nardo at 905-522-1155, ext. 32168.

Booster Group: Obsessive-Compulsive Disorder
This Booster Group is designed for clients who recently completed treatment at the Anxiety Treatment and Research Clinic (ATRC) for Obsessive Compulsive Disorder.  The group occurs monthly and is on a drop-in basis. 

For more information, please call Lisa Di Nardo at 905-522-1155 ext. 32168.

Booster Group:  Posttraumatic Stress Disorder
This Booster Group is designed for clients who recently completed treatment at the ATRC for posttraumatic stress disorder.  The group occurs monthly and is on a drop-in basis.

For more information, please call Lisa Di Nardo at 905-522-1155 ext. 32168.

Youth-Focused Groups

Youth Transdiagnostic Behavioural Therapy Group
The Transdiagnostic Behaviour Therapy (TBT) group is a 12-week therapy group offered through the Anxiety Treatment and Research Clinic (ATRC) for youth (ages 17-25) with principle anxiety disorders (Panic Disorder, Agoraphobia, Social Anxiety Disorder, PTSD, GAD). The main focus is on learning and practicing behavioural techniques (i.e., exposure and activation) to address anxiety and mood-related difficulties. Although less of a focus, cognitive techniques are included to help participants maximize their exposure and activation and to interrupt unhelpful thinking patterns. A unique feature of the TBT group is its additional focus on anxiety-related difficulties and symptoms (i.e., Sleep Disruption, Mild Substance Use, Anger, Worry and Tension, Chronic Pain, and Prolonged Grief/Bereavement). These difficulties are addressed in optional modules which are included on an as-needed basis and are decided upon collectively by each group.

Youth CBT Group for OCD
This is a 12-week therapy group offered through the Anxiety Treatment and Research Clinic (ATRC) for youth (ages 17-25) with a diagnosis of OCD.

Groups for Individuals who have completed traditional CBT:

Mindfulness for Anxiety Group
This 8-week therapy group is for individuals who have completed a previous course of CBT and who are interested in learning mindfulness techniques for coping with residual anxiety symptoms. Topics covered include learning what mindfulness is, how to develop a mindfulness meditation practice, and the benefits of mindfulness for coping with anxiety.

ACTion Group
This group is designed to address the needs of patients with chronic symptoms of anxiety. We are targeting those individuals who have tried a minimum of two CBT groups and despite their efforts have not been successful at making meaningful changes. The group is an Acceptance and Commitment Therapy (ACT) inspired group which runs 10 weeks in duration. The treatment protocol will focus on key ACT principals including: Orientation to ACT, Exploration of Avoidance and Creative Hopelessness, Acceptance and Valued Living, Value-Guided Exposure, and Self-Compassion, and Mindfulness. 

Perfectionism Group
This group is an 8-week course of CBT for those who have already completed a course of CBT for anxiety, but for whom perfectionism remains problematic. Perfectionism is the tendency to hold excessively high standards for performance and toview anything short of perfect as unacceptable. Although there is nothing inherently wrong with holding high standards, perfectionism becomes a problem when those standards cause significant distress or impairment for the individual. This group is for individuals who are very concerned about making mistakes, set extremely high standards for performance, and evaluate themselves/their self-worth primarily based on their ability to meet these standards. Group will include the following components:

  • Education about perfectionism (different types of perfectionism, pros and cons of striving for perfection)

  • Identifying and challenging perfectionistic thinking styles (cognitive distortions, challenging perfectionistic thinking)

  • Identifying areas of self-worth, problems with over-evaluation of achievement, broadening areas of self-worth

  • Increasing self-compassion

  • Identifying perfectionistic behaviours and doing exposure to challenge these behaviours

  • Doing experiments to test out predictions

Other Groups

Crossing Paths Groups
This is a 12-week cognitive behavioural therapy group for individuals experiencing concerns related to both substance use and a mental health diagnosis of a mood and/or anxiety disorder. Group participants learn about the relationship between mental health and addiction, acquire new strategies to cope with these problems, and meet others who experience similar problems and want to make a positive change in their lives.

ATRC Family Education Group
The ATRC recognizes that an anxiety disorder affects not only the individual but also the family. The purpose of this educational group is to provide a friendly and safe group opportunity to connect and educate family members on the symptoms, treatments, medications, community resources and coping strategies for individuals with anxiety disorders. For further information please click on the link to the poster: Family Education Group Poster.

Transdiagnostic Behaviour Therapy Group
The Transdiagnostic Behaviour Therapy (TBT) group is a 12-week therapy group offered through the Anxiety Treatment and Research Clinic (ATRC) for individuals with principle anxiety and affective disorders (Panic Disorder, Agoraphobia, Social Anxiety Disorder, PTSD, OCD, GAD, Major Depressive Disorder, Persistent Depressive/Dysthymic Disorder). The main focus is on learning and practicing behavioural techniques (i.e., exposure and activation) to address anxiety and mood-related difficulties. Although less of a focus, cognitive techniques are included to help participants maximize their exposure and activation and to interrupt unhelpful thinking patterns. A unique feature of the TBT group is its additional focus on anxiety-related difficulties and symptoms (i.e., Sleep Disruption, Mild Substance Use, Anger, Worry and Tension, Chronic Pain, and Prolonged Grief/Bereavement). These difficulties are addressed in optional modules which are included on an as-needed basis and are decided upon collectively by each group.

Managing Life Series
This is a biweekly 1-hour interactive discussion group lead by members of our nursing, occupational therapy, and social work team. It is appropriate for patients receiving treatment in the ATRC who are having trouble finding information and navigating community supports in Hamilton. Topics include but are not limited to: crisis services, LGBTQ, income supports, returning to school, employment resources, housing supports, access to food, and abuse resources.

Lunch and Chat Group
This is a weekly lunch and chat group held on Thursdays from 12-1pm for patients currently in treatment for an anxiety disorder. The group is open and attendance is on a drop-in basis. It is an opportunity to socialize with others, partake in general conversations, and practice using social skills and becoming more comfortable socially.