Can we Change the Demographics of Anxiety Disorders? The Theory and Reality of Prevention and Early Intervention in Anxiety Disorders
Salkovskis, Paul
University of Bath, United Kingdom
We are in the exciting position of having a range of highly effective treatments for anxiety disorders which should be effective for most people. Anxiety should therefore be an unnecessary problem as a result of developments in CBT. Why then do so many people still suffer from these problems? We have yet to see a decrease in the prevalence of anxiety disorders either in the clinic or in the community. It will be suggested that our main failures in the treatment of anxiety not only lie in offering “too little, too late”, but also in being overly tolerant of inappropriate therapy approaches. In this keynote address, consideration will be given to the prospects for primary, secondary and tertiary prevention across the different anxiety disorders and the implications for earler and more effective interventions. There is a risk that such approaches will spread things too thinly to be helpful; it is suggested that we should only be prepared to tolerate dilution of treatment where there is an evidence base to justify this. We should be providing interventions which are at the lowest intensity compatible with effectiveness, but no lower, on the basis of offering the least invasive and most effective treatments as early as possible. Finally, it will be suggested that we need to carefully balance transdiagnostic approaches with our existing good understanding of specificity