Date of Award

12-2-2016

Document Type

Capstone

Degree Name

Doctor of Philosophy (Ph.D.)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences

Department

Nursing

Major Advisor

Dr. Joan Masters

Second Advisor

Dr. Nancy York

Third Advisor

Dr. Robert Caudill

Fourth Advisor

Dr. MAry-Beth Coty

Abstract

Abstract

Background and Significance: Anxiety Disorders affect nearly 18% of adult population annually (SAMHSA, 2013.) Per APA, (1990) & Ashton (1994), prescribers should limit use to short-term crisis or to prepare for therapy. Unintended consequences of benzodiazepines: abuse, dependence, compromised sobriety, withdrawal seizures, rebound anxiety (APA, 1990, p. 35)

Purpose of pilot: To develop/ implement an evidence based pilot program using internet-based, CBT to taper benzos with minimal/no perceived participant distress.

Theoretical Framework: The recovery model (Anthony, 1993).

Project Design: Design. Pilot project using a one-group, pre-test, post-test model.

Sample. Convenience sample of seven clients; (18 years old on long-term benzos)

Setting. Urban community mental health center, 1,900+ adults

Project Design: daily dosage of benzo recorded; administered GAD-7 for baseline score; provided with the tools and education to access tool; recorded active engagement in therapy; dose reduced by one-half pill every month; prescriber monitored client’s subjective experience; monitored use of tool. At conclusion: GAD-7 administered; current dosage of benzo recorded; use/non-use of web-based program recorded; recorded active engagement in therapy services.

Evaluation: All participants reduced /discontinue benzos by end project; all demonstrated acceptable level of anxiety throughout pilot; no participants used tool offered

Keywords: benzodiazepines, anxiety treatment, community mental health

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