Anxiety, OCD, and Trauma

Generalized anxiety disorder

Excessive, hard-to-control worry about many things for 6+ months.

OT: relaxation, stress management, time management, routine.

Panic disorder

Recurrent unexpected panic attacks with fear of having another.

Symptoms: racing heart, shortness of breath, dizziness, fear of dying.

OT approach during panic attack

Stay calm, use a quiet low-stimulation space, give simple directions, and coach slow diaphragmatic breathing and grounding.

Agoraphobia

Fear of places where escape is difficult. Treat with graded exposure to the community.

OCD

Obsessions (intrusive thoughts) and compulsions (repetitive behaviors).

Treatment: ERP and CBT. Do NOT stop or rush the compulsion, but support the client in building tolerance.

PTSD

Exposure to trauma with intrusive memories, avoidance, negative mood changes, and hyperarousal for 1+ month.

OT: grounding, sleep routines, trauma-informed care, graded return to meaningful roles.

Trauma-informed care

Prioritize safety, choice, collaboration, trust, and empowerment. Avoid surprising the client, avoid forced touch, and offer choices.

Grounding technique

Anchors the client in the present using the senses (5-4-3-2-1 technique) or physical awareness.

Progressive muscle relaxation (Jacobson)

Tense then release muscle groups in sequence to reduce physical anxiety.