From Detroit to JVS with Anxiety

Anxdisorder3
Anxdisorder3

Wednesday, December 5 -- A group of researchers from Michigan and UCLA met at the JVS WorkSource Center in Marina Del Rey to discuss anxiety and depression.

Not to worry. The conversation was upbeat. And the hope is the outcome – and a partnership --  will be as well.

Researchers from the University of Michigan Depression Center hope to bring a program on the benefits of cognitive behavioral therapy (CBT) on individuals with social anxiety disorder to Los Angeles. A three-year study of the effects of CBT on a select group of job seekers through JVS Detroit has shown encouraging results and now Dr. Joseph Himle and his team hope to try out the program in L.A.

“If we’re successful in catching people here with social anxiety and in treating and improving employment outcomes, our next project will allow us to track them for larger period of time and learn more about the benefits of this intervention,” said Himle, Associate Director of the University of Michigan's Stress & Anxiety Disorders Program (SADP). “If we’re successful, then our next big step would be to spread the word and find a way to train others in an efficient way around the country to do this work if it’s bound to be helpful.”

In Detroit, a group of job seekers who were identified as having social anxiety disorder were randomly divided into two groups. The first group received the standard vocational services that all JVS clients receive while the second group received additional work (an “intervention” in the form of a class) of CBT assistance in eight two-hour sessions over a four-week period.

JVS Detroit career services counselors administered the class. In addition to getting help with resumes and interviewing, these job seekers also got assistance on becoming more comfortable with people.

Over the duration of its three years, the Michigan study came to just under $1 million. The follow-up research that the team hopes to conduct will require a grant of four or five years and will carry a substantially higher price tag. The hope is to have a Los Angeles program in place while the Michigan research continues. Program administrators plan to apply for a grant through the National Institute of Mental Health.

According to preliminary data from the study, the job seekers with the extra help reported marked improvement in levels of social anxiety, generalized anxiety, depression and job search confidence compared to those who did not get the CBT counseling.

“We have several ideas about how social anxiety interferes with employment,” said Himle.

The SADP researchers believe that job seekers with social anxiety will avoid job interviews and don’t easily network with other people to try to find job leads. Employed individuals who suffer from social anxiety disorder tend not to inform their bosses when things are going badly or when they achieve success.

“We have examples of people working in factories where, if something isn’t working right on the stamping machine, they won’t tell anybody,” says Himle. “It’s a particular challenge in a service-based economy. In some ways, being a shy person in a factory might have been a benefit. You don’t talk much, you do your work, you don’t stay too long at lunch, you’re not the one to organize a union.

“But if you have a job at a hotel or a restaurant, your capability to interact with others is affected. Your comfort and poise are important commodities.”

The Michigan team, which includes social worker and study coordinator Sara Vlnka has a natural partnership with UCLA. Dr. Michelle Craske of UCLA’s Department of Psychiatry has conducted similar research not in a job-seeking setting, but within the primary care. Patients with social anxiety were treated with CBT techniques rather than with extensive medication and were found to make significant progress.

“We didn’t look specifically at work. We looked at functioning in general,” said Craske. “Typical treatment often involves lots of medication, referrals to general counseling and self-help groups, but no skill development. One of the characteristics of CBT is skill development.”

Himle originally thought to set his study in a primary care setting, possibly among welfare recipients. When he was consulting a physician, she pointed out the window of her office to the JVS Detroit building and suggested that Himle consider that agency.

“We found that social anxiety was the biggest predictor of trouble getting off public assistance when it came to the mental health disorders, more than depression, more than  substance abuse, more than PTSD,” said Himle.  “I thought wouldn’t that be interesting to go out there find people with social anxiety, help them with CBT and see if we can get them back to work.”

“We like JVS because of this national network affiliation," he continued. "We thought if we could be successful in one place, wouldn’t it be great to spread the news.”