Session 10 - Worry and Generalized Anxiety Disorder

Summary

In this session, the patient is queried about worry episodes and resulting distress. Among ethnic minority and refugee patients, worry is common, and often triggers somatic symptoms, for example, dizziness and headache; triggers psychological symptoms (e.g., poor attention and concentration); and triggers panic. We have found worry to be a key psychopathological process in many minority and refugee populations. This session addresses worry in many ways, such as eliciting causes, symptoms, catastrophic cognitions, and trauma associations. Many treatments are used, such as modifying catastrophic cognitions and teaching mindfulness, including introducing a new form of mindfulness (tea/coffee mindfulness exercise). As a form of switching attentional focus, to treat worry, we introduce two forms of behavioral activation: encouraging exercise (for example, wall push-ups), and prescribing pleasurable activities.