1. Background information/purpose of this
document 2
2. A brief overview of ADSMs and
their utility. 2
3. A guide to anxiety disorder
classifications and ADSMs. 2
4. Where to access additional
support 3
This
guide is designed to to support therapists working with clients referred
through NHS Talking Therapies with anxiety disorder presentations.
This guidance covers the use of ADSMs (Anxiety Disorder Specific Measures) to support
therapists and clients to measure and discuss change and recovery throughout therapy.
This
guidance is based on the NHS Talking Therapies Manual v7.1. The full document
can be viewed here: IAPT
Manual (england.nhs.uk)
2.
A brief overview of ADSMs and their utility
ADSMs are sensitive measures that look at the particular
features and symptoms of specific anxiety disorders.
Most clinicians will be familiar with the GAD-7, which is a
generalised measure of anxiety symptoms, but there are many symptoms and
features of different types of anxiety that this does not highlight or measure.
Using the GAD-7 alone means specific issues that could be worked on in therapy
could be missed at assessment, during formulation and treatment planning, and
throughout the therapy journey.
Recent evidence (Clarke, 2022) suggests that using a
specific ADSM alongside the GAD7 can enhance therapists’ and clients’
experiences of tailoring therapy and targeting particular symptoms and can
improve clients’ overall functioning, as measured by the WSAS (Work and Social
Adjustment Scale).
Further information on the evidence base for the
effectiveness of using problem-specific ADSMs is available in Prof. David
Clarke’s paper here: ADSMs_Recovery_IAPT.pdf
(pcmis.com)
3.
A guide to anxiety disorder classifications and
ADSMs
How to use this table
This table contains a list of working diagnoses for anxiety
disorders, along with the recommended ADSM to use for the working diagnosis
based on the client’s presentation and reported symptoms. Depression is
included because the majority of clients presenting with depression will also
present with features of anxiety and vice versa. The use of PHQ9 is therefore
recommended by NHS Talking Therapies best practice for all clients.
Important: The working diagnosis selected in MPB needs to be
the correct working diagnosis for the ADSM you are going to use, e.g. if your
working diagnosis is social anxiety, this must be selected in order for the
SPIN to be available for completion.
|
Primary presenting problem
|
Depression symptoms present?
|
Anxiety symptoms present?
|
|
Depression
|
PHQ9
|
GAD7
|
|
Generalised anxiety disorder
|
PHQ9
|
GAD7
|
|
Mixed anxiety and depression
|
PHQ9
|
GAD7
|
|
Chronic pain (in the context of
anxiety/depression)
|
PHQ9
|
GAD7
|
|
Agoraphobia
|
PHQ9
|
Mobility Inventory (MI)
|
|
Social Anxiety/Social Phobia
|
PHQ9
|
Social Phobia Inventory (SPIN)
|
|
Other phobias
|
PHQ9
|
GAD7 (specific phobia measures under
development)
|
|
Health anxiety
|
PHQ9
|
Health Anxiety Inventory (HAI)
|
|
OCD
|
PHQ9
|
Obsessive-Compulsive Inventory (OCI)
|
|
Panic disorder
|
PHQ9
|
Panic Disorder Severity Scale (PDSS)
|
|
PTSD
|
PHQ9
|
PCL-5 (PTSD checklist for DSM-5)
|
|
Body Dysmorphia/Body Dysmorphic
Disorder (BDD)
|
PHQ9
|
Body Image Questionnaire (BIQ) Weekly
|
4.
Where to access additional support
If you require additional support around determining a
client’s working diagnosis, or using ADSMs, the VHG clinical support team can
be contacted at
network.clinical@vitahealthgroup.zohodesk.eu
if you need any further information on the above.
Authors: Liam Wilson, Clinical lead/Liz Smith, Senior Counsellor
Publish date: 12/07/2024
Last updated: 09/10/2024