Week 8: An Unsuccessful Search for Safety

Hello, and welcome back to my blog! This week I continued my on-site work at Small Brooklyn Psychology, interviewing more therapists and neuropsychologists. I was also able to read “Generalized Anxiety Disorder (GAD) as an Unsuccessful Search for Safety,” which gave me a better understanding of treatment for GAD. Lastly, I researched the causes of GAD while also gathering information on the potential downsides of treatments such as dialectical-behavioral therapy (DBT) and cognitive-behavioral therapy (CBT).

Firstly, I want to give a summary of the numerous conversations that I was able to have with mental health professionals. This past week, I interviewed two therapists and one neuropsychologist. As I stated in my last blog, each of the mental health professionals has a very strong background and tends to work with those ages 7–18. When interviewing the neuropsychologist, I learned a lot about the process of diagnosing GAD, which is essentially centered around a 250-question assessment and an interview with both the patient and their parents. This then allows the neuropsychologist to diagnose if the patient is struggling with GAD, and if they are, they will be referred to either a therapist or a psychiatrist, depending on the severity of the diagnosis and the associated symptoms. Interviewing the therapists also gave me a lot of insightful information. Both therapists, similar to those last week, stated that using a combination of DBT and CBT is suggested when treating GAD. With this said one of the therapists primarily uses DBT, as his training was primarily DBT, but still works in CBT with nearly all his patients. I also learned the importance of parental involvement. Both therapists schedule monthly meetings with parents to make sure that the environment at home changes along with the skills the patient learns to ensure that the child is changing positively. Lastly, I asked the therapists about their ideas on having more accessibility for those who can’t afford private practice therapy, and they stated that there should be more accessibility in schools, free workshops for parents, especially for immigrant families, and DBT workbooks.

Secondly, I read the article “Generalized Anxiety Disorder (GAD) as an Unsuccessful Search for Safety.” This article provided insight into the complexity of GAD, as it demonstrates how people unsuccessfully try to cope with the symptoms of GAD. People with GAD are highly sensitive, particularly to potential threats, and experience a range of issues, largely due to an insufficiency of safety signals. This lack of safety leads to one’s anxiety persisting over time, causing the individual to remain in a state of worry. The article emphasizes that without reliable safety signals, those with GAD tend to overestimate potential threats and struggle with maintaining a sense of safety. As a result, they engage in avoidance behaviors and frantic searching, often without relief. While the safety perspective provides valuable insights into managing GAD, it also acknowledges certain limitations within the safety signal model itself.

I also researched the causes of GAD. There is no clear-cut answer to what primarily causes GAD. Some will say it is more environmental-based, meaning how one is brought up in a home. If a child is surrounded by anxious parents, they will likely develop anxiety. Some will also say it’s more genetic-based, so if someone’s parent has GAD, then the child will likely have GAD. In my opinion, and that of other neuropsychologists, it is a combination of both. I believe this to be the case because if a child has a stressful upbringing, like child abuse or bullying, they are going to be more susceptible to developing an anxiety disorder. On the other hand, individuals may inherit a predisposition to anxiety from close relatives. The combination of genetics and environment suggests that each person’s experience with GAD is unique, and this remains the same for treatment approaches that address both inherited predispositions and learned behaviors.

Lastly, I researched the potential downsides of treatments such as dialectical-behavioral therapy (DBT) and cognitive-behavioral therapy (CBT). Some of the most common downsides I found were cost, race, age, and parent-child cooperation. The cost of receiving these treatments, especially in private practice, requires a decent amount of money. This is due to high demand as well as the fact that the fact that insurance is not always allowed in private practices. In terms of race, these evidence-based treatments were not utilized on individuals such as black individuals, and there is a noticeable cultural difference in understanding or believing in therapy. For age, some younger individuals find it harder to comprehend practices in both CBT and DBT, and this requires the therapist to adapt quite frequently. Lastly, cooperation can be an issue, as some parents give in to their kids too easily. This causes the kids to not get better, as the accommodation is rewarding the behavior.

Next week, I plan to finish interviewing the staff. I will also begin to write my final paper for the project. Finally, I will hopefully garner more responses to my questionnaire. Thank you for reading my blog, and I will update you all next week!

Sources:

Butler, G., Carroll, J. S., Craske, M., Jacobs, W. J., Rachman, S., Rapee, R., Salkovskis, P., Sartory, G., Steketee, G. S., Association, A. P., Barlow, D., & Beck, A. T. (2002, May 29). Generalized anxiety disorder (GAD) as an unsuccessful search for safety. Clinical Psychology Review. https://www.sciencedirect.com/science/article/pii/027273589490040X

https://www.nhs.uk/mental-health/conditions/generalised-anxiety-disorder/overview/#:~:text=The%20exact%20cause%20of%20GAD,violence%2C%20child%20abuse%20or%20bullying