Adjustment Issues

Advanced Therapeutic Solutions for Anxiety provides therapy for the treatment of Adjustment Disorder.

After experiencing a significant stressor, there can be intense emotional or behavioral symptoms that develop, usually within three months of the stressor. It can be one stressor (e.g., a relationship break-up) or several stressors (e.g. getting fired; family conflict), that can be recurrent (e.g., seeing your ex during the holidays) or continuous (finding out you have a chronic illness). Sometimes the stressor is a new transition (e.g., getting married, having a baby, moving away for college) that creates significant distress and impairs with daily functioning. The stressor can affect one person or an entire community (e.g., natural disaster). Emotional and behavioral symptoms can include depressed mood, anxiety, behavioral misconduct, or all three.

Adjustment disorders are common, ranging from 5-20% in an outpatient setting, and up to 50% in a psychiatric hospital setting. It is also short-term, ranging from three months to six months after the stressor or its consequences have ended. Treatment for adjustment disorders includes differentiating between normative adjustment and significant impairment that impacts a person’s social, educational, or occupational functioning. Differentiating between adjustment disorder and other conditions (e.g., depression, anxiety, bereavement) is also important during the course of treatment. If symptoms persist beyond six months, other disorders are considered. 

It is possible that adjustment disorder will remit on its own, but it is also possible that symptoms can worsen and lead to another disorder, such as major depressive disorder, an anxiety disorder, or alcohol/drug abuse or addiction. 

Treatment is often short term, solution-focused, and aims to address the symptoms that are present. To address depressed mood, cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) are used to help identify thought errors and focus on thoughts and actions that can help get back to daily functioning. For anxiety symptoms, learning to turn off the anxiety loop and increasing use of relaxation strategies is incorporated. For behavioral conduct issues (which is a common reaction to life stressors in children and teens) emotion regulation, anger management, processing the stressor, and improving communication are targeted in treatment.

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It is possible that adjustment disorder will remit on its own, but it is also possible that symptoms can worsen and lead to another disorder. 

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Clinical Procedures for Adjustment Issues Evaluation and Outpatient Treatment

Diagnostic Evaluation

A 90-min diagnostic interview is conducted to assess the presenting problem, symptoms severity (onset, duration, frequency), review areas of life that have been impacted (daily functioning, work, home), collect history, including family history of anxiety or depression, and review what you hope to gain from treatment at ATSA. Specific questions and or measures may be administered during the session for diagnostic purposes.

Starting at 275

CPT CODE: 90791

Treatment Planning Session

A 60-min session to review how the first sessions have felt to you, present hypotheses, and collaborate on a treatment plan. Treatment approaches may include Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP). Treatment dose is also discussed, specifically if weekly 60-min outpatient sessions will be effective, or if intensive doses (e.g., 3-hr sessions) should be considered. Likewise, location of where sessions should occur for most effective outcome is also discussed and planned out. Decisions are made as to whether to start with therapy sessions only, allowing for the future addition of psychopharmacological treatment as an adjunct, or whether to start with combined treatment, (or in rare cases to start with psychopharmacological treatment before CBT, ACT, or ERP). 

Starting at 125

CPT CODE: 90837

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