Management of Anxiety disorders and Related Conditions

Effective management of anxiety disorders and related conditions will need to combine elements of psychological, medical, social and environmental treatments that are acceptable to the person. The following elements should be considered:

Social and Environmental treatments

It may be more helpful, in the first instance, to ensure that a person with intellectual disability is receiving appropriate levels of support in their home and the community. Anxiety may occur because a person is socially isolated, has little opportunity to access the community and feels at risk when they do. Ensuring that a person has appropriate social, occupational and vocational activities and adequate carer support to access such activities can increase an individual’s confidence and provide the individual with support to follow behavioural plans.

Psychological treatments

There is some evidence that psychological therapies are effective in people with intellectual disability and anxiety disorders, although some adaptations may be required. For example, using pictures (rather than words), social stories and behavioural techniques (rather than cognitive) may make the therapy more accessible. Generalised anxiety disorder, specific phobias and social phobias often respond well to psychological treatments, and exposure and response prevention is highly effective in obsessive compulsive disorder. Psychological therapies can occur on an individual basis or in a group setting. It is important to establish trust and rapport as psychological therapies for anxiety disorders are themselves distressing and frightening. Increased distress can cause a person to lose motivation and disengage from treatment. Anxiety symptoms have often been present for long periods of time and short term therapy is unlikely to be effective in their treatment. It may be useful to use extra resources to assist in discussing topics that make people anxious, and the “Books Beyond Words” series is an example of some of the available options.