Follow-Up Schedule for Moderate to Severe Anxiety
For patients with moderate to severe anxiety, assess treatment response at 4 weeks and 8 weeks after initiating treatment, with monthly follow-up thereafter until symptoms stabilize. 1
Initial Follow-Up Timeline
Week 4 Assessment:
- Evaluate symptom relief using standardized validated instruments (GAD-7, HADS, or BAI) 1
- Assess medication side effects and adverse events if pharmacotherapy was initiated 1
- Determine patient satisfaction with treatment 1
- Check adherence to the treatment plan 1
Week 8 Assessment:
- Repeat standardized symptom measurement 1
- If little improvement despite good adherence, adjust the treatment regimen (add psychological intervention to medication, change medication, or switch from group to individual therapy) 1
- Re-evaluate the treatment plan if patient satisfaction is low or barriers to treatment exist 1
Ongoing Monitoring
Monthly Follow-Up:
- Continue monthly assessments until symptoms subside, as patients with anxiety often avoid treatment 2
- Verify compliance with referrals and treatment recommendations 2
- Use outcome measures routinely to gauge treatment efficacy and monitor adherence 2
Treatment-Specific Considerations
For Psychological Interventions:
- Mental health professionals should assess treatment response at pretreatment, 4 weeks, 8 weeks, and end of treatment 1
- Most effective psychological interventions in primary care maintain treatment gains at follow-up assessments ranging from 2-12 months, with 77.8% maintaining benefits 1
For Pharmacotherapy:
- SSRIs and SNRIs require regular monitoring at 4 and 8 weeks for symptom relief, side effects, and patient satisfaction 1
- After achieving remission, continue medications for 6-12 months before considering discontinuation 3
Critical Decision Points
At 8 Weeks: If symptoms are stable or worsening despite good adherence, you must modify the approach by:
- Adding a psychological intervention to pharmacotherapy 1
- Changing the medication class 1
- Switching from group to individual therapy if applicable 1
Long-Term Maintenance:
- For patients who respond to treatment, periodically reassess (every 3-6 months) to determine the need for continued treatment 4
- Treatment gains from CBT are maintained at 12+ months for generalized anxiety disorder (small to medium effect) and social anxiety disorder 5
Common Pitfalls to Avoid
- Do not wait beyond 8 weeks to adjust treatment if there is minimal improvement—this delays recovery and increases patient suffering 1
- Do not assume patients are following through with referrals; actively verify attendance at the first appointment and identify barriers 1
- Do not rely on clinical impression alone—always use standardized instruments (GAD-7, HADS, BAI) to objectively track progress 1
- Do not discontinue follow-up prematurely—anxiety disorders are chronic conditions requiring sustained monitoring even after initial response 3, 6