Reducing Anxiety and Stress in Primary Care Patients
Anxiety
About this trial
This is an interventional treatment trial for Anxiety focused on measuring anxiety, primary health care, Veterans
Eligibility Criteria
Inclusion Criteria:
- Age 18 years or older
- Veteran seen in the Syracuse VA Medical Center primary care clinic in the past year
- Screen positive for current (past 2 weeks) clinically significant anxiety symptoms (8 on Generalized Anxiety Disorder-7)
Exclusion Criteria:
- Inability to communicate in English (as assessed by study staff)
- Report or demonstrate hearing impairment that would preclude telephone screening (as assessed by study staff)
Inability to demonstrate informed consent
- defined as not being able to comprehend the study description as assessed by study staff and/or not being able to answer the comprehension of consent questions
- have a diagnosis of dementia or severe cognitive impairment (defined by primary care provider or self-report, or having a diagnosis in Problem List)
- screen positive for cognitive impairment (3 or more errors on cognitive screener)
Have a diagnosis of obsessive-compulsive disorder (OCD) or serious mental illness (SMI) in Problem List
- i.e., psychotic disorders, bipolar disorder
- Have an encounter diagnosis of post-traumatic stress disorder (PTSD) within the past 2 years OR screen positive for PTSD (3 or more on PC-PTSD-5)
Currently in psychotherapy/counseling for anxiety and/or depression, defined as any of the following within the past 30 days:
- attending specialty mental health sessions [excluding a single intake session]
- attending 2 or more Primary Care-Mental Health Integration sessions
- Being hospitalized for mental health treatment
- Report severe depressive symptoms (20 or more on Patient Health Questionnaire-9)
At imminent risk of suicide
- defined as being identified as imminent risk based on study staff's suicide risk assessment [verified by the PI] and in need of intensive treatment
- e.g., hospitalization] to ensure safety
- Started or had dosage change in psychotropic medication for anxiety or depression in the past 30 days
Sites / Locations
- Syracuse VA Medical Center, Syracuse, NY
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Brief anxiety intervention
Usual PC-MHI care
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care