Management of General Anxiety Disorder in Primary Care

Background information

  • 32-year-old female complaints of difficulties handling uncertainty
  • Inability to relax due to restless feelings
  • Persistent anxiety and worrying (Rutter & Brown, 2017)
  • Difficulty concentrating and overthinking plans
  • Fear of making certain decisions and indecisiveness

History of present illness

  • She was diagnosed with post-traumatic stress disorder (PTSD) two years ago and treated with Cognitive Behavioral Therapy (CBT) (Jordan et al., 2017)
  • Diagnosed with Stage IV Small Cell Carcinoma six months ago
  • Started experiencing moderate symptoms two weeks ago that progressed with time
  • She has been suffering throbbing headaches at night that extends several hours
  • Hands are clammy and cold to touch and are profusely sweating

Social and family medical history

  • Her mother was diagnosed with general anxiety disorder in 2017
  • Her older sister committed suicide in 2019 after a divorce with her husband
  • She likes spending most of her free time indoors playing video games
  • She is not a member of any social or religious group (Rutter & Brown, 2017)
  • She rarely shares her feelings and issues affecting her with anyone

Past medical history and medications

  • She developed chronic physical health problems
  • Confirmed previous mental health disorder
  • She denied previous use of substances and alcohol (Jordan et al., 2017)
  • She also denied misuse of any comorbid substance
  • Previously received medications for PTSD.

Treatment plan

  • Antidepressants such as the selective serotonin reuptake inhibitor (SSRI), norepinephrine reuptake inhibitor (SNRI) classes, and serotonin.
  • Buspirone is effective in eliminating anxiety (Rutter & Brown, 2017)
  • Benzodiazepines help relieve anxiety
  • Psychotherapy including psychological counseling or talk therapy
  • Cognitive-behavioral therapy

State and Federal Regulations

  • I live in Miami Florida
  • Licensed practitioners are authorized to offer treatment and prescribe drugs
  • Behavioral health drugs can only be prescribed by certified psych-mental health nurse practitioners
  • Offenders risks facing legal chargers or losing their licenses
  • Affordable Care Act (ACA) improves behavioral health care by enhancing accessibility of health services

Impact of State and Federal Regulations

  • State laws improve patient’s safety
  • Ensure competency of nurses responsible for drug administrators
  • ACA enhances the accessibility of quality care.
  • Reduce the cost of treatment
  • Offer guidance

Community resources in Miami

  • Banyan Health System
  • Florida Department of Children and Families Adult Mental Health
  • Douglas Gardens Community Mental Health Center
  • Care Resource Community Health Centers
  • New Horizons Community Mental Health Center

How to determine the need for more support

  • Poor response to intervention
  • Extreme expectations
  • Development of new symptoms
  • Persistent pain
  • Poor cooperation

Facilities for urgent intervention and assessment

  • Jackson Behavioral Health Hospital
  • Miami Dade Community Services
  • New Horizons Community Mental Health Center
  • Rogers Behavioral Health
  • Opa-Locka Mental Health Center

Resources for poor patients

  • Miami Dade Community Services
  • Motivational Institute for Behavioral Health, LLC
  • Restoring Minds Counseling Services Miami Fl.
  • Dade Family Counseling CMHC
  • Miami Counseling & Resource Center

Resources for short-term primary mental health provider

  • The health of Mind, Inc
  • Live Well Therapy Group (Jordan et al., 2017)
  • Face To Face Mental Health Services, LLC
  • Beach House
  • Clean Recovery Centers

Ethical Considerations

  • Informed consent
  • Data privacy and confidentiality
  • Professional boundaries
  • Access to care
  • Malpractice

Potential legal issues

  • Data breaches when patient’s data is exposed to a third party
  • False claims in case of generation of incorrect record (Abdolpour et al., 2019)
  • Anti-kickback to avoid an unauthorized exchange of remuneration
  • Impact of Stark Law to hinder unnecessary testing and fraudulent
  • Lawsuits can occur in case of negligence or poor quality work

Mitigating potential risks and necessary follow-up

  • Communicate clearly
  • Review and update policies
  • Engage the patient and family members (Rutter & Brown, 2017)
  • Follow-up needed to determine response to medication
  • The follow-up to evaluate the presence of new issues


Abdolpour, G., Nasiri, M., Mafakheri, M., Mansouri, K., & Abdi, R. (2019). Structural equation modeling of intolerance of uncertainty and symptoms of depression and general anxiety disorder: Investigation of the mediating role of rumination. Iranian Journal of Psychiatry and Clinical Psychology, 24(4), 400-415. Web.

Jordan, P., Shedden-Mora, M. C., & Löwe, B. (2017). Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory. PloS one, 12(8), e0182162. Web.

Rutter, L. A., & Brown, T. A. (2017). Psychometric properties of the generalized anxiety disorder scale-7 (GAD-7) in outpatients with anxiety and mood disorders. Journal of Psychopathology and Behavioral Assessment, 39(1), 140-146. Web.

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PsychologyWriting. (2023) 'Management of General Anxiety Disorder in Primary Care'. 14 September.


PsychologyWriting. 2023. "Management of General Anxiety Disorder in Primary Care." September 14, 2023.

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PsychologyWriting. "Management of General Anxiety Disorder in Primary Care." September 14, 2023.