Process - Physician - Fraser Health Authority

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Costs and Benefits of AnxietyCheck below to see what benefits anxiety has brought you and what it has cost you.BENEFITSYou are anxious about doing a good enoughjob so you work harder than others.Your employer lets you know how much youare valued, which makes you feel good.You are anxious that people won’t like you soyou do everything you can to please them.People talk about how kind, helpful andgenerous you are.You are afraid that things will go wrong so youalways plan very carefully.You are very vigilant and often catch thingswhen they start to go wrong so that you canhead off bigger problems.You are afraid to make mistakes so you do athorough job of any tasks you take on.People know they can rely on you to doeverything well.You are afraid that if your life gets out of controlthere will be total chaos so you are veryorganized and orderly.People perceive your orderliness as a valuabletrait at work or at home.COSTSWhen you are not at work you still think about work,worrying if you did things correctly.You may take work home.Your stress affects your family because you are toobusy and irritable to spend time with them.People get used to you being helpful and start to takeadvantage of you.People stop appreciating your efforts so you have totry harder to please them.No one seems to think your needs are importantand you feel resentful.You over plan everything and get stressed if the leastlittle thing goes wrong.Your over planning takes fun and spontaneity out ofevents.You are constantly on guard and can’t relax.You are so afraid of a mistake that you do things overand over, which takes an excessive amount of timeand makes you less productive.You procrastinate because you don’t think you can dothe task perfectly.You spend so much time organizing and trying tokeep things under control that you feel constantlystressed and overwhelmed.You are tough to live with because you requireeveryone else to be as organized as you.• The goal is to balance the benefits and costs so that you keep some of the benefits and don’tpay such a heavy price. This is hard to do because anxiety tries to push you to do more: morechecking, more planning, more working, more organizing, more worrying, and more avoiding.• What are the benefits of limiting anxiety? Feeling more relaxed and comfortable; being able toplay and have fun; other people being more comfortable around you; getting some of your ownneeds met; being appreciated even if you are not perfect; feeling better about yourself; sleepingbetter…and so on.• Your first task in limiting anxiety is to recognize what it costs you and others in your life. As youbegin to apply anxiety management strategies, you will often be tempted to go back to your oldanxious habits because your anxiety may increase temporarily. It will be helpful to come backto this page to re-affirm for yourself that you are already paying too much because of youranxiety. It is worth your effort to limit anxiety and not let it run (and ruin) your life.Patient Empowerment Anxiety Manual VIHA.March.2010 91
How Anxiety WorksTHOUGHTSBODYFEELINGSBEHAVIOURSManaging anxiety is easier if you understand how thoughts, feelings, behaviours and bodysensations are linked together and affect each other.In the following example, the same situation seems to produce very different reactions.The way you think about or interpret the situation will influence how you feel and behave.ANXIETY REACTIONSituation: Husband is late coming home.Thoughts: Maybe he’s had an accident.I know something terrible has happened.I can’t stand it if he’s hurt; how will wemanage without his salary?Feelings: Worried, anxiousBody: Heart racing, sweating, light headedBehaviours: Phones hospitals, frets andpaces, yells at kids, forgets to make dinner.HELPFUL REACTIONSituation: Husband is late coming home.Thoughts: Maybe he’s working a bit late.I’ll give him an hour and then call the office;I’m not going to panic until I know for suresomething bad has happened.Feelings: Mild concernBody: Butterflies in stomachBehaviour: Distracts herself by getting onwith usual tasks.Neither woman knows the truth of what has happened. If nothing has happened, the firstwoman is likely to be cranky and angry when her husband finally gets home. The secondwoman will want an explanation but will probably be quite calm.If something bad has happened, the first women will be overwhelmed as she is alreadypanicky, the second woman will handle it better because she is not as panicked from thestart.In this example different thoughts produced different feelings and behaviors.Patient Empowerment Anxiety Manual VIHA.March.2010 92
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SteppedCareLevel 1PSP Mental Health
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Fold back this page before administ
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CBISCOGNITIVE BEHAVIOURAL INTERPERS
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Table of ContentsINTRODUCTION. . .
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IntroductionThe following modules h
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TipsTeachingSelling Strategies• E
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Flow ChartsThis module contains flo
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Patient NeedsTryThe Circle of Depre
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AnxiousSymptomsTryOverwhelmedChaoti
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Assessment ModuleThe Assessment Mod
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5 Energy levela. How would you rate
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15 Phobiasa. Any unrealistic or exc
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21 CAGEHow many drinks might you ha
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DIAGNOSTIC SCREENING WORKSHEET (CON
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Problem List Action PlanACTIVATIONR
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Self-Assessment QuestionnaireName:
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Self-Assessment ProfilePleaser: Hig
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Self-Assessment ProfileOver-Thinker
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Understanding Depression- Frequentl
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Depression: System-Wide CrashDepres
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Activation ModuleThe Activation Mod
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Depression’s Energy BudgetEvery d
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Small GoalsThe concentration, fatig
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Problem SolvingDepression can make
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Chunk the DayStrategies that give p
Page 51 and 52: Appreciation Exercise“Good for Me
Page 53 and 54: The Circle of DepressionCognitive-b
Page 55 and 56: Common Thinking ErrorsThe situation
Page 57 and 58: THOUGHT CHANGE PROCESS (CONTINUED)T
Page 59 and 60: Thought StoppingDepression often ma
Page 61 and 62: Good Guilt / Bad GuiltA world witho
Page 63 and 64: Setting LimitsMost of us like to be
Page 65 and 66: Is Anger a Problem for You?Tom arri
Page 67 and 68: Stress ResponseIntroduction to Rela
Page 69 and 70: Variation - Box BreathingABDOMINAL
Page 71 and 72: Body ScanPurpose• Body scan is a
Page 73 and 74: Stress BustersPurpose• Shorter te
Page 75 and 76: MindfulnessPurpose• Mindfulness i
Page 77 and 78: BreathMINDFULNESS MEDITATION (CONTI
Page 79 and 80: Healthy Habits for SleepingDepressi
Page 81 and 82: IT’S TRUE: YOU ARE WHAT YOU EAT!
Page 83 and 84: The Wellness WheelPHYSICALGROWTHSEL
Page 85 and 86: CBISCognitive Behavioural Interpers
Page 87 and 88: FLOW CHARTS……………………
Page 89 and 90: PANIC DISORDER• Anxiety “System
Page 91 and 92: The Many Faces of AnxietyPanic Diso
Page 93 and 94: Medical ConsiderationsMost Common M
Page 95 and 96: Anxiety“System-Wide Explosion”A
Page 97 and 98: Resources for Self-HelpOnline Resou
Page 99 and 100: GAD: Self-Assessment QuestionnaireN
Page 101: GAD: Self-Assessment ProfileHard Dr
Page 105 and 106: Panic CircleEvent (public speaking)
Page 107 and 108: Your Emotional Thermometer• Imagi
Page 109 and 110: Anxiety EquationAnxiety arises out
Page 111 and 112: 2. When something bad happens, I wo
Page 113 and 114: Coping CardsAnxious people often ma
Page 115 and 116: Problem SolvingAnxiety is strengthe
Page 117 and 118: Example: Kelly begins by making a l
Page 119 and 120: D.E.S.C. ScriptAssertiveness doesn
Page 121 and 122: Application forPsychiatric Medicati
Page 123 and 124: APPENDIX 2: WOMEN’S MENTAL HEALTH
Page 125 and 126: Pharmacotherapy in the Perinatal Pe
Page 131: FAMILY PHYSICIAN GUIDE | ADDRESSING
Page 134 and 135: Olanzapine (Zyprexa)Tablets, wafers
Page 136 and 137: Consortium forOrganizationalMentalH
Page 138 and 139: 3. Gather details on current andpre
Page 140 and 141: Task Two: ADVISE1. Provide meaning
Page 142 and 143: SUPPORTED SELF‐MANAGEMENT FOR DEP
Page 144 and 145: TABLE OF CONTENTSIntroduction 1What
Page 146 and 147: INTRODUCTIONTake a moment now to as
Page 148 and 149: WHAT IS DEPRESSION?The two most com
Page 150 and 151: WHAT CAUSES DEPRESSION?People becom
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WHAT CAUSES DEPRESSION?ThoughtsEach
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WHAT CAUSES DEPRESSION?EmotionDepre
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WHAT CAUSES DEPRESSION?ActionDepres
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WHAT CAN YOU DO ABOUT DEPRESSION?MI
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MORE ABOUT MEDICATIONMedication is
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ANTIDEPRESSANT SKILLSIn this sectio
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REACTIVATING YOUR LIFEStep 1: Ident
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REACTIVATING YOUR LIFESmall DutiesE
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REACTIVATING YOUR LIFEStep 2: Choos
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REACTIVATING YOUR LIFEStep 3: Set r
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REACTIVATING YOUR LIFEStep 4: Carry
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THINKING REALISTICALLYNegatively di
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THINKING REALISTICALLYStep 1: Learn
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THINKING REALISTICALLYStep 4: Pract
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SOLVING PROBLEMS EFFECTIVELYStep 1:
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REDUCING THE RISK OF RELAPSEPlan ah
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Congratulations! You have now made
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SUGGESTED READINGON DEPRESSION AND
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DIETThe Canada Food GuideGuidelines
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SLEEPStress, anxiety, and depressio
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CAFFEINECaffeine stimulates the sym
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CHALLENGING DEPRESSIVE THOUGHTSSitu
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PROBLEM SOLVINGACTION ADVANTAGES DI
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AnxietyDementiaDementiaBipolar155
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Practice Support ProgramGeneralized
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Montreal Cognitive Assessment(MoCA)
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Serial 7s: Administration: The exam
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Appendix CNAME OF PATIENTStandardiz
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Item 11Scoring WORLD backwards (ins
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Appendix CStandardized Mini Mental
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SCORING THE MOOD DISORDERQUESTIONNA
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FORM 4MENTAL HEALTH ACT[ Sections 2
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CommunityMHSU ReferralFormBounceBac
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REFERRAL FORMMental Health and Subs
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MENTAL HEALTH AFTER HOURSPLEASE LEA
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DOCUMENTATION REQUIRED UPON REFERRA
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Adult Eating Disorders ProgramRefer
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Medical History:Medical causes of l
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Who Are We?This is a specialized pr
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Fraser South Eating Disorders Progr
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Fraser South Eating Disorders Progr
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Fraser East:This program is part of
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Fact SheetPanic Disorder GroupDoes
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Fact SheetGeneralized Anxiety Group
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4 th Floor Sherbrooke Centre Tel (6
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Early Psychosis Intervention Progra
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*Additional Resources*For Informati
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Mental Healthand Addiction… suppo
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Fraser Health Mental Healthand Addi
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ADDICTION SERVICESAddiction Service
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ADDICTION SERVICESYouth Addictions
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ADDICTION SERVICES6. Long-term Resi
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MENTAL HEALTH SERVICESMental Health
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MENTAL HEALTH SERVICESDelta Mental
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MENTAL HEALTH SERVICES4. Community
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MENTAL HEALTH SERVICESMinistry of E
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MENTAL HEALTH SERVICES7. Residentia
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Mental Health & AddictionsHEALTHY L
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Client name: ______________________
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Client name: ______________________
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Taking Wellness to Heart! Metabolic
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Mental Health and Substance Use Rev
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Collaborative Care Process Map-Epis
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Fax the Special Authority Request t
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o o o o o o o • • • o o o o o
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Process - Physician - Fraser Health Authority

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