CAMHS National and Specialist Services Directory - SLaM National ...

Anxiety Service
Location: Maudsley Hospital
Mode: Outpatient
Effect of CBT treatment
Percentage
100
80
60
40
20
0
GAD SAD OCD
Percentage reduction in DSM-IV diagnoses of generalised anxiety
disorder (GAD) (n=15), separation anxiety disorder (SAD) (n=10),
and obsessive compulsive disorder (OCD) (n=10) following eight
to 12 weeks of CBT in the clinic.
Pre
Post
Our service is for young people with difficulties caused by
intense worrying, fearfulness, phobic avoidance, nervousness
and panic. We provide comprehensive diagnostic and family
assessments to identify anxiety disorders and the impact they
are having on the young person and family’s functioning.
Where an anxiety disorder is present and requires treatment,
we offer consultation to services about treatment, and
provide individual and family-based CBT.
Our research leads the way in improving evidence-based
treatments for childhood anxiety disorders. Families seen
in the clinic are often invited to participate in ongoing
research projects. Our staff provide training for clinicians
on the assessment and treatment of childhood anxiety
disorders in our clinic, nationally and internationally.
Criteria
Eligibility
• Up to 18 years old
• Male or female
• Known or possible diagnosis of an anxiety disorder, including:
––
Generalised anxiety
––
Social phobia
––
Separation anxiety
––
Panic and agoraphobia
––
Specific phobias
––
Obsessive compulsive disorder
––
Health-related anxiety
Interventions which may be provided
• Structured diagnostic assessment and formulation
• Specialist, anxiety-focused CBT
• Family-focused CBT, where appropriate
• Treatment sessions outside the clinic involving exposure
to feared situations
• Assistance in treatment planning via local mental health services
Exclusion
• Presence of another psychiatric disorder or problem requiring
more urgent assessment or treatment
Outcomes
• Reduced symptoms
• Improved quality of life for the young person and their family
Care option Description Cost Unit Code
Outpatient
“ I started coming to the Anxiety Service
because I had panic attacks and problems
going to school and getting out to places…
I have learnt a lot of strategies here and have
overcome a lot of my difficulties. I learnt how
to control my breathing, how to reason with
my thoughts, how to look for evidence for
my thoughts (drawing charts and diagrams
to help). I have learnt how to get my worry
level down, and have compared my scores
on some questionnaires to old times and
seen how well I have done.” Former patient, age 11
Assessment
Assessment involves face-to-face interviews with the young person
and their parents (both separately and together), by a clinical
psychologist. The session includes a semi-structured diagnostic
interview for ICD-10 and DSM-IV disorders, and standardised self
and parent reported measures of symptoms and functionality. The
assessment may include a standardised assessment of intellectual and
academic attainment. A comprehensive report detailing the diagnostic
formulation, treatment and care recommendations is provided.
Treatment Treatment is offered on a weekly basis, with sessions between 60
and 90 minutes. Length of individual sessions and treatment follows
clinical need, but treatment generally lasts between six and 14
sessions. Treatment is provided by clinical psychologists specialising
in cognitive and behavioural approaches, who are also clinical
researchers and CBT trainers.
Consultation
Consultation with clinical services is offered on assessment methods
(including selection of appropriate measures), formulation
(including differential diagnosis), care planning and treatment, service
development and training. Consultation may also involve meeting
at our clinic, the young person’s local area, over the phone or via email.
Referrals are accepted from: Contacts: Address:
Consultant psychiatrists
Mental health professionals
GPs
Schools and school
counsellors
GP consortia
Consultant paediatricians
Professor Derek Bolton, Consultant Clinical Psychologist
Dr Patrick Smith, Consultant Clinical Psychologist
Dr Eleanor Leigh, Clinical Psychologist
Charlene Clancy, Administrator
£404 Per assessment 60531
£268 Per session 60532
£268 Per consultation 90312
Anxiety Service
Michael Rutter Centre
Maudsley Hospital
De Crespigny Park
Denmark Hill
London SE5 8AZ
Tel: 020 3228 2657
Fax: 020 3228 5011
Email: charlene.clancy@slam.nhs.uk
30 31