April 5 9:00am - 4:30pm

Changing the Anxious Mind — Rapidly

Washington, DC

ADAA Annual Anxiety and Depression Conference
Preconference Workshop 

This advanced workshop will outline and demonstrate a rapid-gain treatment model for panic disorder, social anxiety, phobias, and OCD. Cognitive-behavioral therapy, or CBT, is a first-line treatment for the anxiety disorders and OCD. Yet despite its efficacy, it can require a substantial amount of time, discomfort, and cost for the client, which can lead to treatment refusal, dropouts, and lack of engagement. Preliminary studies are now exploring the efficacy of briefer treatments for both anxiety disorders and OCD.

We will start with a short review of these results and those on rapid gain, including published data on this model (Wilson, Neziroglu, Feinstein & Ginsberg, “A New Model for the Initiation of Treatment for Obsessive-Compulsive Disorder: An Exploratory Study,” Journal of Obsessive-Compulsive and Related Disorders, in press).

Then we will explore a method of initiating treatment that is engagement-oriented versus compliance-oriented and that encourages clients to adopt a simple yet paradoxical mindset that is manifest through provocative strategies after session 1, leading to positive change before session 2. We will outline the treatment strategy, step-by-step, and illustrate each stage with brief  professionally videotaped segments of therapist-client interaction in the first two sessions of treatment with two different clients: a woman with claustrophobia, panic attacks, and fear of flying and a man with severe OCD. The treatment protocol — made up out of whole cloth within the first session — directs the entire therapy process.

The principal goal is to induce clients to voluntarily, purposely, and aggressively seek out and embrace uncertainty and anxiety moment-by-moment as their ticket out of suffering. Once they receive feedback from successful behavioral experiments, the second goal is for clients to adopt a long-term self-help protocol to respond to moment-by-moment doubt and distress. Attention will focus on how the clinician presents the paradigm in a manner persuasive enough to counter the dread of symptoms and their feared consequences.


Learning Objectives

Participants will be able to do the following at the end of this session:

1.    Guide a client in logically dismantling the common dysfunctional frames of reference of an anxiety disorder or OCD. 
2.    Construct with a client a new, internally consistent paradoxical frame of reference.
3.    Teach a client how to activate that new frame of reference moment-by-moment while approaching and engaging in threatening situations.


Anxiety and Depression Association of America
8701 Georgia Ave., Suite 412
Silver Spring, MD 20910