FAQ

Anxiety can be the main or 'primary' problem or it can be a secondary problem, which means that it is a symptom of another disorder. Depression and substance or alcohol misuse are often associated with high levels of anxiety, but in these cases lasting benefit will come from treating the underlying problem rather than focusing solely on the anxiety symptoms.

In primary anxiety disorders, the symptoms tend to have followed a set pattern over several months or years. In these cases, the anxiety symptoms occur independently of other mental health problems, however they can be intensified when coupled with depression and life stress.

The service is geared towards helping clients with primary anxiety disorders and it is important to give this question some consideration before seeking referral for assessment. 

Clients that suffer with associated problems such as depression or alcohol misuse for example will be accepted for assessment and treatment as long as it is made clear the underlying difficulty is an anxiety disorder.

Referrals to the Anxiety Disorder Programme is through a GP or consultant psychiatrist.

If you are worried about your own mental health or that of a relative/friend, your first point of contact should be your GP. They will discuss your mental health treatment needs with you.

Following assessment by your GP, they may recommend that you are referred for an assessment of your mental health at one of St Patrick's University Hospital's community mental health clinics called Dean Clinics. You may be referred to the specialist Anxiety Disorder Dean Clinic on Capel St or one of our other general Dean Clinics for assessment.

The assessment involves the use of standardised rating scales and assessment tools and is carried out by a multidisciplinary team under the direction and supervision of Dr Michael McDonough, the consultant on the team and the director of the Anxiety Disorders Programme.

A detailed report is complied and sent to the referrer. A copy of this report can be made available to you if you wish.

At this assessment meeting, a comprehensive treatment plan is devised which may involve referral for inpatient admission (based on Grattan ward), referral to attend the Anxiety Programme as a day patient, (which includes individual cognitive behavioural therapy), referral for individual cognitive behaviour therapy alone on an outpatient basis, advice on drug treatment or recommendations for other forms of therapy depending on what is felt to be most helpful.

Cognitive behavioural treatments are highly effective in anxiety disorders and target exaggerated danger beliefs and safety behaviours in a collaborative way with the aim of breaking the vicious cycle and helping the sufferer achieve greater confidence in the face of what they fear.

By learning about the vicious cycle of anxiety and by challenging beliefs and behaviours at the centre of the anxiety problem, sufferers gradually master their fears and regain their functioning.

CBT work can be greatly supported by meditational strategies such as mindfulness meditation, occupational therapy and various drug treatments. Serotonin boosting anti-depressant drugs are very helpful in easing anxiety states and combine nicely with CBT work.

Sedative anti-anxiety drugs can also be used in the short term to ease the worst of the anxiety during the acute phase. Best results are achieved by carefully focused cognitive behavioural therapy combined with other forms of help as needed.

A decision about referral to individual CBT is made at assessment. For most anxiety sufferers it is the main component of the treatment plan. Referrals then go on a short waiting list for allocation to a specialist anxiety therapist at the Dean Capel.

This is a short term, structured therapy, where both client and therapist play an active role working collaboratively to help the client achieve their goals. It focuses on identifying and evaluating factors contributing to problem maintenance with a view to altering inaccurate thoughts and unhelpful behaviours that keep the problem going. In addition to attending weekly sessions of an hour's duration, there is an emphasis on agreed work or tasks being carried out between sessions

Alternatively, GPs can refer directly to the CBT department and bypass a specialist assessment at the anxiety clinic

Groups are facilitated in a way that encourages openness and trust. Most clients will need time to talk about their difficulties and there is no expectation for individuals to share before they’re ready.

However, to fully benefit from the programme, a fair degree of engagement, participation and openness will be necessary.

The Dean Clinic is easily accessible from the hospital via the Luas. The exact address is:

The Dean Clinic @ Capel,

Suite 501,

Capel Buildings,

Mary's Abbey (Capel Street),

Dublin 7.

The Aftercare Programme for the Anxiety Disorders Programme is currently being developed and details will be available in the near future. The aftercare package is envisaged to be made available to all who have completed a full Level one cycle of the Programme (either stream) and is aimed to run as part of a day care package, which should be covered by most health insurance providers.