Case Report of a Brief Modular Anxiety Intervention for Integrated Primary Care: Addressing Clinician Feasibility Concerns and Barriers to Using Manualized Treatments

Authors

Katherine Buckheit, VA Center for Integrated HealthcareFollow
Robyn L. Shepardson, VA Center for Integrated HealthcareFollow
Luke Mitzel, VA Center for Integrated HealthcareFollow
Risa B. Weisberg, Boston University School of MedicineFollow
Stephen A. Maisto, Syracuse UniversityFollow
Jennifer Funderburk, VA Center for Integrated HealthcareFollow

Abstract

Individuals with anxiety symptoms commonly present in primary care settings and prefer behavioral health (versus pharmacotherapy) treatment, but behavioral health interventions are underutilized. Primary care behavioral health (PCBH) models, in which embedded behavioral health providers deliver behavioral treatment in primary care, may help address the gap in provision of anxiety treatment. However, evidence-based anxiety treatment options feasible for delivery in primary care are limited, and clinicians often report concerns about using manualized interventions. Recent recommendations by the U.S. Preventative Services Task Force to increase anxiety screening among adults in primary care may result in increased identification of individuals with anxiety symptoms who may benefit from behavioral anxiety treatment. However, clinicians may be unable to meet the need for behavioral anxiety treatment due to lack of brief, manualized anxiety interventions. This article presents a case report from a pilot randomized controlled trial of an evidence-based, modular anxiety intervention designed for primary care settings. Session-by-session intervention content is described along with patient outcome data. We discuss the course of treatment in relation to commonly cited concerns about using manualized treatments, particularly within the brief treatment format required for efficient PCBH practice. We offer concrete strategies along with illustrative session dialogue to demonstrate successful delivery of an evidence-based, manualized anxiety intervention in primary care and facilitate utilization of this and similar interventions by behavioral health providers.

Recommended Citation

Buckheit, Katherine; Shepardson, Robyn L.; Mitzel, Luke; Weisberg, Risa B.; Maisto, Stephen A.; and Funderburk, Jennifer (2024) "Case Report of a Brief Modular Anxiety Intervention for Integrated Primary Care: Addressing Clinician Feasibility Concerns and Barriers to Using Manualized Treatments," The Journal of Integrated Primary Care: Vol. 1: Iss. 3, Article 1.
Available at: https://digitalcommons.pcom.edu/jipc/vol1/iss3/1