Carrie Steckl earned her Ph.D. in Counseling Psychology with a Minor in Gerontology from Indiana University – Bloomington in 2001. She has spent over ...Read More
When we think of professionals who can treat anxiety, we often think of physicians who can prescribe anti-anxiety medications or mental health professionals who can address the cognitive and emotional aspects of this challenge.
But how often do we think of nurses as clinicians who can effectively treat anxiety? Not much – that is, until recently.
A study published last month in The Lancet showed that when nurses and related clinic staff were trained in basic principles of cognitive-behavioral therapy, they were able to use those techniques to help patients with health anxieties. In other words, the nurses were able to help their patients stop worrying so much about being sick when they’re not.
If you read my blog regularly, you know that I’m a big fan of cognitive-behavioral therapy. In this approach, the clinician and client (or patient, depending on the setting) examine the client’s thoughts in order to identify unhelpful thinking patterns. They then work together to modify those thinking patterns into healthier ones. The theory assumes that thoughts impact feelings, which in turn impact behavior. It all starts with how we think. And in my opinion (as well as the objective estimation of thousands of research studies), it’s quite effective.
I can see how nurses could be trained to use some basic techniques, such as countering. But I would hope that the nurses would be required to practice using the techniques in a clinical training environment before setting them loose to try them on real patients. It would also be important to ensure that the patient really is healthy and that his or her worries are unfounded before applying any cognitive-behavioral strategies.
The study focused on 444 people between the ages of 16 and 75 whose responses on a targeted questionnaire suggested that they had a high level of health anxiety. The patients came from a variety of specialty clinics, including heart and gastrointestinal health centers.
The patients were randomly assigned to either an experimental group, in which they received 5 to 10 individual cognitive-behavioral therapy sessions, or a comparison group, in which they did not receive the treatment but instead received normal medical care and reassurance from their doctor that they did not have a disease.
After one year, the researchers tested the patients again for level of health anxiety. Interestingly, they found that health anxiety had dropped to normal levels for 14 percent of those in the experimental group, compared to only 7 percent among the comparison group. Others in the experimental group also experienced decreases in anxiety levels, and these benefits persisted for two years.
While 14 percent is a pretty modest number, it still suggests that a brief application of cognitive-behavioral therapy can – for some – provide relief beyond what standard medical care can provide. The next question is whether the cost of training nurses in these techniques and providing the treatment is worthwhile when compared to potential outcomes among people who are struggling with health anxieties.
Tyrer, P., Cooper, S., Salkovskis, P., et al. (2013). Clinical and cost effectiveness of cognitive-behavior therapy for health anxiety in medical patients: A multicenter randomized controlled trial. The Lancet, Early Online Publication, doi: 10.1016/S0140-6736(13)61905-4