CONTENTS
(1) Sources
(2) Transdiagnostic interview
(3) Transdiagnostic Functional Assessment of Anxiety
(1) Sources
Abramowitz - Exposure Therapy for Anxiety
(2) Transdiagnostic interview
I. Anxiety cues
A. External/environmental situations and stimuli
B. Internal triggers: bodily signs, sensations
C. Intrusive thoughts, ideas, doubts, images, memories
II. Feared consequences of exposure to anxiety cues
III. Safety-seeking behaviors
A. Passive avoidance
B. Checking and reassurance seeking
C. Compulsive rituals
D. Brief/covert (or mental) rituals
E. Safety signals
IV. Valued directions and goals
Transdiagnostic Functional Assessment of Anxiety
(1) History of the problem (personal and family)
When did the problem begin? What factors contributed to the development of the problem? How has the problem changed over time? What effects has the problem had on your life? Do you have any family members who have had similar problems?
(2) Anxiety cues or triggers
Cues or triggers for anxiety include: (A) Situations or objects; (B) Body sensations; or (C) Intrusive thoughts, ideas, images, or memories.
What kinds of things cause you to experience anxiety or fear? These may include (A) Situations or objects; (B) Body sensations; or (C) Intrusive thoughts, ideas, images, or memories.
(3) Feared consequences of exposure to anxiety cues
What do you fear will happen if or when you experience a cue for your anxiety?
What do you believe about the likelihood and severity of danger?
(4) Safety-seeking behaviors
Safety-seeking behaviors are strategies you use to try to control or reduce anxiety and bring about a feeling of safety. There are seven major types of safety behaviors: (A) Passive avoidance; (B) Checking and reassurance seeking; (C) Compulsive rituals; (D) Mental avoidance; (E) Coping behaviors; (F) Safety signals; and (G) Accommodation by others. It is important to identify your safety behaviors and understand the reasons you use them.
(A) Passive avoidance
Passive avoidance is refraining from engage in activities or situations that are associated with an anxiety cue.
What kinds of activities or situations do avoid because of fears of encountering a cue or trigger for your anxiety?
(B) Checking and reassurance seeking
Checking behaviors are aimed at obtaining information (sometimes about something that is already known) in an attempt to feel less anxious. Reassurance seeking involves asking other people questions (sometimes repeated or similar questions) in a quest to feel better.
Do you engage in repeated checking or reassurance seeking? In what ways? What do you fear will happen if you don’t do these things?
(C) Compulsive rituals
Compulsive rituals are intentional, repetitive actions that are performed in response to a sense of pressure to act, often according to certain rules. That are aimed at reducing anxiety, removing a perceived danger, or preventing feared consequences. They can be overt observable behavior (e.g., washing hands in a certain way) or can be mental acts (such as conjuring up a “good” image to replace a “bad” one or trying to suppress).
Do you engage in any repetitive actions that you feel compelled to perform in a certain way to feel better or prevent bad things from happening? What do you fear will happen if you don’t do these things?
(D) Mental avoidance
Mental avoidance involves purposeful attempts to avoid, distract from, or suppress thoughts, images, or memories.
In what ways do you try to avoid or get rid of certain kinds of thoughts, images, or memories that make you feel anxious? What do you fear will happen if you don’t do these things?
(E) Coping behaviors
Coping behaviors are things people do to make themselves feel less anxious or safer in the presence of things that make them anxious (e.g., using relaxation techniques to reduce feelings of anxiety or taking evasive actions such as sitting down to prevent fainting during a panic attack).
What do you do to make yourself feel less anxious or safer when you are in the presence of things that make you anxious? What do you fear will happen if you don’t do these things?
(F) Safety signals
Safety signals are stimuli associated with the absence or reduced likelihood of feared events. The stimuli can be a place (e.g., an aisle seat), a person, or an object (e.g., cellphone; anti-anxiety medication). Sometimes just the mere presence of these stimuli can help a person feel less anxious.
Are there any places, people, or objects whose presence helps you feel safer? What do you fear would happen if these things weren’t present?
(F) Accommodation by others
Sometimes significant others make accommodations for people who have anxiety to make things easier for them (e.g., driving).
Do people in your life do things to help you avoid things that make you anxious or to help reduce your anxiety?
(5) Functional effects of anxiety control efforts
Attempting to avoid, reduce, or control anxiety comes at a certain cost, in terms of time, effort, or missed opportunities.
In what ways does attempting to avoid or control anxiety affect your life?
What do these efforts cost you in terms of time, effort, missed opportunities, or other costs?
In what ways do these efforts affect important areas of your life, such as self-care, relationships, work?
(6) Valued directions and goals
If anxiety was no longer an issue for you, what would you do differently?
What would you do more of and what would you do less of?
What goals would you pursue?
How would things be different in important areas of your life, such as self-care, relationships, work?