Our outpatient clinic offers weekly
cognitive-behavioral therapy (CBT) in either group or individual format.
However, many clients prefer to come in for treatment on a daily basis.
There are several reasons to consider such a program:
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Preliminary evidence suggests that treatment, particularly in the
earlier stages, may be more efficacious when sessions are massed (e.g.,
daily) than when they are spaced (e.g., weekly).
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Clients who have not responded optimally to less intensive
interventions may respond well to intensive treatment.
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Some clients will find it more convenient to come for treatment for a
briefer period of time, rather than stretch out their treatment. This may
be especially true for clients who have difficulty adjusting their work
schedules, or who come in from out of town.
Our intensive program consists of cognitive-behavioral therapy that
includes a strategy called exposure. Exposure-based CBT is the most
effective known psychological treatment for anxiety disorders. Clients work
with a therapist individually to develop a step-by-step plan to confront
feared situations while refraining from unhelpful responses such as
avoidance, compulsive behavior, or rituals that give a false sense of
safety. Over time, clients learn that they can handle these situations, and
they find that their fear is reduced considerably. There is a wealth of
scientific evidence showing that the majority of clients respond very well
to this form of therapy. The staff at the Anxiety Disorders Center are
expert clinicians and scientists who specialize in the application and study
of CBT for anxiety disorders in adults, children, and adolescents.
Is this an inpatient, partial hospital, or residential program?
The intensive program at the Anxiety Disorders Center is a specialized
education and therapy program that does not fit into any of these
categories. Clients do not usually stay overnight at The Institute of
Living; rather, they stay in a local hotel.
(Click here for a list of hotels we have
provided for you.) They do not spend the entire day here; rather, each visit lasts
from 1.5-2 hours, and clients are expected to spend additional time during
the day completing homework exercises on their own.
Is this service covered by my insurance plan?
Please be advised that most insurance plans do not pay for the intensive program,
and our staff members are not contracted with any insurance companies to
provide this service. Therefore, the client will be responsible for all
costs. We will provide you with an invoice, and you are free to seek
reimbursement from your insurance company if you wish. Clients who wish to
use their insurance plans may receive weekly treatment through our
outpatient clinic.
Does “intensive” mean that this treatment is harder than regular
treatment?
Not necessarily. The word “intensive” means that treatment is
delivered on a daily, rather than weekly, schedule. This allows you to
receive immediate feedback and support from your therapist about your
exposure homework exercises. However, we recommend difficult exposures for
most of our clients with obsessive-compulsive disorder and panic disorder,
regardless of how frequently they come in. Therefore, intensive therapy is
more focused and possibly more effective, but is not necessarily more
difficult than weekly treatment.
Our intensive program for obsessive-compulsive disorder (OCD) consists of
15 sessions delivered 5 days per week for 3 weeks. Each session lasts 1.5-2
hours. After the initial assessment, treatment consists of exposure and
ritual prevention whereby clients gradually face feared activities,
objects, and situations while refraining from compulsive behavior. Several
research studies indicate that exposure and ritual prevention is both
effective and well tolerated by adults and children with OCD. Exposure and
ritual prevention is considered a first-line treatment of choice for OCD.
Our intensive program for panic disorder (with or without agoraphobia)
consists of 5 daily sessions delivered within a single week. Each session
lasts 1.5-2 hours. After the initial assessment, treatment consists of
interoceptive exposure (in which clients gradually face feared
physiological sensations that have triggered panic attacks for them in the
past) and in-vivo exposure (in which clients gradually face activities that
they have avoided due to fears of having a panic attack). They are also
encouraged to refrain from their usual "safety signals" that prevent them
from learning that they can handle these situations without panicking.
Several research studies indicate that CBT is both effective and well
tolerated by clients with panic disorder. CBT is considered a first-line
treatment of choice for panic disorder.
School refusal is defined as refusal to attend classes or difficulty
remaining in school for an entire day without a support person present.
Children often refuse school due to strong feelings of anxiety, such as
fears of separating from their parents or caregivers. The School Refusal
Program begins with an initial evaluation of the child's school records by
an educational consultant and clinical social worker or psychologist, as
well as a consultation with the child's school. Next, a clinical
psychologist interviews the child and parents in order to determine the
nature of the child's problems. The team reviews all of the information
together in order to determine whether the School Refusal Program would be
appropriate. Treatment is tailored to match the child's specific needs, with
the immediate goal of returning the child to school as quickly as possible.
Depending on the child's concerns, treatment may involve gradual exposure to
feared situations, skills training, anxiety management training, or helping
parents with limit setting and rule enforcement. The treatment team will
work closely with school personnel to assist them in providing an
appropriate educational plan and transition for the child. By the beginning
of the second week, it is expected that the child will begin to attend
school at least part time. The School Refusal Program includes 15 sessions
of CBT, delivered 5 days per week for 3 weeks. Each session lasts 1.5 to 2
hours. CBT is provided individually or with the child's parents or
guardians.
How do I get more information or make an appointment?
Contact Dr. David Tolin, Director of the Anxiety Disorders Center, at
(860) 545-7685 for more information or to make an appointment for an initial
assessment. For more information only, you may also e-mail Dr. Tolin at
