PSYC1024 · Anxiety, Mood and Stress
Treatment
Week 9 surveys the evidence-based treatment of anxiety and mood disorders — psychological interventions (notably CBT and its cognitive and behavioural components, and exposure therapy) and pharmacological options — and shows how the choice of treatment follows from the underlying model. It reinforces the course's scientific, evidence-based framing of clinical practice, and it is final-exam examinable (the 40% Inspera final covers all topics). (Week 9's own lecture slides were not among the materials this guide was built from, so the treatments below are discipline-standard first-year canon — confirm against your Moodle notes.)
What this chapter covers
- 01Evidence-based practice: best research evidence + clinical expertise + client values
- 02Cognitive Behavioural Therapy (CBT): thoughts, feelings and behaviours interact; first-line for anxiety and depression
- 03Cognitive restructuring: identifying and challenging automatic thoughts and distortions
- 04Exposure therapy: graded confrontation without avoidance/safety behaviours → extinction of fear
- 05Behavioural activation for depression: re-engaging rewarding, values-consistent activity
- 06Other therapies: ACT, mindfulness-based interventions, interpersonal therapy
- 07Pharmacology: SSRIs (first-line), SNRIs, benzodiazepines (short-term), mood stabilisers for bipolar
- 08Who prescribes: medical practitioners/psychiatrists — psychologists cannot; stepped care matches intensity to severity
Match the evidence-based treatment to the case and model
- +1(a) Exposure therapy. Graded confrontation with driving-related cues while dropping avoidance and safety behaviours lets the conditioned fear extinguish and the catastrophic prediction be disconfirmed (extinction / inhibitory-learning model). It directly targets the avoidance that maintains the phobia; it usually sits within a broader CBT programme.
- +1(b) Behavioural activation. Scheduling and re-engaging in rewarding, values-consistent activities restores response-contingent positive reinforcement and interrupts the withdrawal-and-downward-spiral that maintains depression (behavioural model). Cognitive restructuring would additionally target the negative cognitive triad.
- +1State the CBT rationale that unifies both: thoughts, feelings and behaviours interact, so changing maladaptive cognitions and behaviours changes emotion. That is why CBT (with exposure for anxiety, behavioural activation for depression) is first-line for both classes of disorder.
- +1Medication: SSRIs (selective serotonin reuptake inhibitors) are the first-line pharmacological treatment for depression and most anxiety disorders, increasing synaptic serotonin. They are prescribed by medical practitioners or psychiatrists — psychologists cannot prescribe (Week 1). CBT and pharmacotherapy have comparable short-term efficacy for many conditions, and combination or stepped care is used for more severe cases.
Key terms
- Cognitive Behavioural Therapy (CBT)
- The first-line psychological treatment for anxiety and depression. Premise: thoughts, feelings and behaviours interact, so changing maladaptive cognitions and behaviours changes emotion. Components include psychoeducation, cognitive restructuring, behavioural strategies, homework and relapse prevention.
- Cognitive restructuring
- The CBT technique of identifying and challenging automatic negative thoughts and cognitive distortions (e.g. Beck's negative triad) and replacing them with more balanced, evidence-based appraisals.
- Exposure therapy
- Systematic, graded confrontation with feared stimuli without avoidance or safety behaviours, so fear extinguishes and catastrophic predictions are disconfirmed (extinction/inhibitory learning). Variants include in vivo, imaginal, interoceptive and systematic desensitisation.
- Behavioural activation
- A treatment for depression that schedules and re-engages rewarding, values-consistent activities to restore positive reinforcement and interrupt the withdrawal-and-downward-spiral of low mood.
- SSRIs
- Selective serotonin reuptake inhibitors — the first-line medication for depression and most anxiety disorders, increasing serotonin in the synapse. Prescribed by medical practitioners or psychiatrists (not psychologists).
- Stepped care
- Matching the intensity of treatment to the severity of the disorder — lower-intensity interventions first, escalating as needed. CBT and pharmacotherapy have comparable short-term efficacy for many conditions, and combination helps severe cases.
Treatment FAQ
What is CBT and why is it first-line?
Cognitive Behavioural Therapy is built on the idea that thoughts, feelings and behaviours interact, so changing maladaptive cognitions (via cognitive restructuring) and behaviours (via exposure or behavioural activation) changes how you feel. It has strong evidence across anxiety and depression, which is why it is the first-line psychological treatment for both, usually delivered with psychoeducation, homework and relapse prevention.
How does exposure therapy work?
By deliberately dropping the avoidance and safety behaviours that maintain anxiety. Through graded, repeated confrontation with the feared stimulus — in vivo, imaginal or interoceptive — the conditioned fear extinguishes and the catastrophic prediction is disconfirmed (you learn the feared outcome does not happen). It directly reverses the maintenance-by-avoidance cycle from Weeks 5 and 7.
What medications are used for anxiety and depression?
SSRIs (selective serotonin reuptake inhibitors) are first-line for depression and most anxiety disorders; SNRIs are an alternative; benzodiazepines are fast-acting anxiolytics used only short-term because of dependence risk; and mood stabilisers such as lithium are used for bipolar disorder. All are prescribed by medical practitioners or psychiatrists — psychologists cannot prescribe, which is the Week 1 distinction resurfacing.
Can AI help me with the treatment material?
Yes. Sia can help you match treatments to disorders and to their maintaining mechanisms, explain how exposure and behavioural activation work, and lay out the medication classes and who prescribes them — step by step. It mirrors how the content is assessed at UNSW; it does not sit the final for you, and UNSW academic-integrity rules apply.
Exam move
The examinable skill in Week 9 is linking model → mechanism → treatment, so revise the treatments beside the disorders rather than as a separate list. For anxiety, tie exposure to maintenance-by-avoidance (it works by dropping avoidance so fear extinguishes); for depression, tie behavioural activation to lost positive reinforcement and cognitive restructuring to Beck's negative triad. Hold the CBT premise — thoughts, feelings and behaviours interact — as the through-line that makes it first-line for both. On pharmacology, learn the four classes and their one-line indications (SSRIs first-line; SNRIs alternative; benzodiazepines short-term only; mood stabilisers for bipolar), and never forget the prescribing rule from Week 1 (psychologists cannot prescribe). Know that CBT and medication have comparable short-term efficacy and that stepped care and combination treatment handle severity. Because Week 9's own lecture materials were not among the materials this guide was built from, confirm specifics on Moodle. Ask Sia for fresh case-to-treatment matching drills.
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