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Study: Primary Care Doctors Can Treat Anxiety Effectively

Anxiety disorders are extremely common, and many people seek treatment for their anxiety from a primary care physician rather than a mental health specialist. Primary care doctors often are the first point of contact for anxiety sufferers because they already have a relationship with the patient and because patients do not always have easy access to trained mental health providers, so it is important that primary care providers have access to effective tools to treat anxiety disorders.

A newly published study, conducted by Michelle Craske and colleagues from the Department of Psychology at the University of California, Los Angeles, looks at the use of cognitive behavioral therapy (CBT) and psychotropic medication to treat anxiety, in a study designed to mimick real-world conditions. More than 1000 patients were randomized to either undergo the Coordinated Anxiety Learning and Management (CALM) collaborative care program or receive the usual treatment from their primary care physician. Depending on patient preference, the CALM intervention included pharmacotherapy, computer-assisted CBT, or both; usual care was continued treatment of medication and/or counseling by the current primary care physician and, if needed, referral to a mental health specialist.

According to the researchers, who note a lack of highly trained mental health providers available in primary care settings, they "designed the CBT program to be used by persons with minimal or no training in mental health." Their study found that the CALM intervention was more effective at decreasing anxiety due to generalized anxiety disorder, panic disorder, and social anxiety disorder.

Dr. Stefan Hofmann of Boston University, who was not involved in the study, summed up the importance of the findings by saying, "I think the main study takeaways for clinicians are that [CBT] for anxiety disorders is effective in clinical practice, it can be effectively and easily trained even in people who have not been trained before in this approach, and it can have long-lasting and positive consequences."

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