Experience of implementing an adult educational approach to treating anxiety disorders.

This paper describes the background to the development and delivery of a self-help package for anxiety disorders. Evidence of effectiveness is summarized. The paper outlines the intervention and describes the experience of two mental health nurses, who set out to assess its acceptability, evaluate its outcomes in routine clinical practice and assess the feasibility of its delivery by mental health nurses. Acceptability of the intervention was high, judged by retention and attendance rates. The pilot study produced promising clinical outcomes, especially for people with depression secondary to anxiety. Clinical measures showed significant improvements from pre-course to 6-month follow-up in anxiety, psychological well-being and depression. The outcomes suggest that appropriately trained mental health nurses could deliver the intervention as a routine treatment. The paper concludes by discussing future plans, including a randomized controlled trial and implementation in primary care.

Unreliable evidence.

As the need for effective evidence-based practice comes under close scrutiny we investigate the effectiveness of three interventions; thought suppression, reassurance and relaxation, that are routinely offered to clients. These strategies have very little evidence to support their continued use. The article continues by discussing and describing situations where more helpful evidence-based interventions are better suited.

Using EMDR to treat post-traumatic stress disorder in a prison setting.

This article describes the treatment of a young man who developed post-traumatic stress disorder (PTSD) following the sudden unexpected miscarriage of his unborn child. He was diagnosed with this anxiety disorder while serving a term of imprisonment. He was treated with a controversial psychological treatment for PTSD, eye movement desensitisation reprocessing (EMDR) therapy, during one, 1-hour session. After this session, his progress was monitored by a further three follow-up appointments at 1 week, 1 month and 3 months, where the self-report questionnaires were repeated and compared with pre-treatment scores. These demonstrated improvement post-treatment and at a 3-month follow-up session. The discussion arising from the treatment will concentrate on EMDR as an effective treatment for PTSD, particularly within a prison setting. Data from recent research highlight the potential risks of PTSD within a community population and the implications for midwives and nurses who treat and care for traumatized patients are discussed.