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I am currently completing my undergraduate research thesis on self-affirmations measured with anxiety. I am trying to see if the self-affirmation task reduces anxiety after. I found the Brief Anxiety Scale and am trying to find out what it is best used with, but my search of articles has not made the uses clear to me.

For what is the scale best used? Are there different scales that might instead be recommended for my research?

Thank you in advance to anyone who can provide assistance!

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    $\begingroup$ Welcome to Psychology.SE @AmeliaWard. Asking for "scales you should use" can be closed for being opinion based, so I made a slight adjustment to your question to "scales you could use" $\endgroup$ – Chris Rogers Jun 18 '18 at 18:06
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Short Answer

The Brief Anxiety Scale is one of many Pychometric Rating Scales (Tyrer, et al. 1984) used to assess necessary Routine Outcome Measures (BACP, 2016; Harmon et al., 2007; Lambert and Shimokawa, 2011; Simon et al., 2012).

The scale which is recommended for your research will depend on your reseach requirements. Some scales are quick to complete as they are shorter than others, but longer ones can provide more detail where you feel they are needed. You need to assess for yourself which scale suits the requirements and then use the one most appropriate.

More Detailed Answer

Routine Outcome Measures

After gaining informed consent from the client, it is a good idea to obtain routine outcome information and devise outcome measures:

  • before any therapy begins,
  • after each session, and
  • after therapy ends

because Routine outcome measures support the therapeutic process by enabling the therapist and the client to monitor progress (BACP, 2016; Harmon et al., 2007; Lambert and Shimokawa, 2011; Simon et al., 2012), and can play an important role in measuring service quality and lead to improvements.

You especially need to implement Routine Outcome Measures when dealing with severe anxiety as your duty of care to your client extends outside the therapy room as far as reasonably practicable. Post-therapy measures may need to include post therapy talks to calm the client at the end of the session if they are particularly anxious due to something which they have brought forward towards the end of the session.

Pychometric Rating Scales for Anxiety

The rating of anxiety is a long-established psychometric exercise and there are more than 20 instruments available (Tyrer, et al. 1984). There are subject completed scales and observer completed scales. The authors of these scales emphasise that they are not diagnostic instruments and should only be used with patients who are diagnosed as having anxiety states. However, in clinical practice anxiety is often mixed with other emotions and it is difficult, if not impossible, to separate the anxiety element (Tyrer, 1984).

Subject Completed Rating Scales

These rating scales take the form of questionnaires which the client in therapy would fill in. The Brief Anxiety Scale (Tyrer, et al. 1984) is one of these rating scales suitable for recording anxious symptoms.

Patient Health Questionnaires (Spitzer, et al., n.d.) can also be used for rating scales in order to form a basis for devising outcome measures. All of the questionnaires can be used but the GAD-7 questionnaire — a 7 question sheet — is designed specifically for anxiety. These come with an instruction manual on how to interpret the results.

Observer Completed Rating Scales

These rating scales take the form of questionnaires which the therapist would fill in as a record for future reference. One observer scale for anxiety is the Hamilton Rating Scale for Anxiety (Hamilton, 1959). However, Hamilton did not consider the scale to be in its final state and Snaith, et al. (1982) modified the scale, which afterwards only contains six items. Other observer scales for anxiety include the Buss Rating Scale (Buss, et al. 1955) and the Anxiety Status Inventory (Zung, 1971) but they have never achieved the popularity of the Hamilton Rating Scale for Anxiety (Tyrer, et al. 1984).

Which scale might be recommended for your purposes?

The scale which is recommended for your purposes will depend on your requirements. Some scales are quick to complete as they are shorter than others and may be more beneficial due to the short time needed to complete them. Would it seem to be too laborious to the client? But on the other hand longer ones can provide more detail where you feel they are needed. You need to assess for yourself which scale suits the requirements and then use the one most appropriate.

References

BACP (2016). Children and Young People Practice Research Network (CYP PRN): A toolkit for collecting routine outcome measures [PDF] Available at: https://www.bacp.co.uk/media/2355/bacp-cyp-prn-toolkit-for-collecting-routine-outcome-measures.pdf

Buss, A. H., Wiener, M., Durkee, A., & Baer, M. (1955). The measurement of anxiety in clinical situations. Journal of Consulting Psychology, 19(2), 125-129. DOI: 10.1037/h0048964

Hamilton, M. A. X. (1959). The assessment of anxiety states by rating. Psychology and Psychotherapy: Theory, Research and Practice. British Journal of Medical Psychology, 32(1), 50-55. DOI: 10.1111/j.2044-8341.1959.tb00467.x

Harmon, S. C., Lambert, M. J., Smart, D. M., Hawkins, E., Nielsen, S. L., Slade, K., & Lutz, W. (2007). Enhancing outcome for potential treatment failures: Therapist–client feedback and clinical support tools. Psychotherapy research, 17(4), 379-392. DOI: 10.1080/10503300600702331

Lambert, M. J., & Shimokawa, K. (2011). Collecting client feedback. Psychotherapy, 48(1), 72. DOI: 10.1037/a0022238 PDF: https://www.researchgate.net/profile/Jose_Garrido13/post/the_cooperation_between_empathy_and_congruence_in_the_therapeutic_relationship/attachment/59d6365fc49f478072ea42e3/AS:273673120878601@1442260164528/download/Norcross_evidence-based_therapy_relationships.pdf#page=23

Simon, W., Lambert, M. J., Harris, M. W., Busath, G., & Vazquez, A. (2012). Providing patient progress information and clinical support tools to therapists: Effects on patients at risk of treatment failure. Psychotherapy research, 22(6), 638-647. DOI: 10.1080/10503307.2012.698918 PDF: https://www.researchgate.net/profile/Lambert_Michael/publication/236664707_Effects_of_providing_patient_progress_feedback_and_clinical_support_tools_to_psychotherapists_in_an_inpatient_eating_disorders_treatment_program_A_randomized_controlled_study/links/0c96051969ab0c091b000000.pdf

Snaith, R. P., Baugh, S. J., Clayden, A. D., Husain, A., & Sipple, M. A. (1982). The clinical anxiety scale: an instrument derived from the Hamilton anxiety scale. The British Journal of Psychiatry, 141(5), 518-523. DOI: 10.1192/bjp.141.5.518

Spitzer, MD, R. L., Williams, J. B. & Kroenke, MD, K. (n.d.) Patient Heath Questionnaire (PHQ) Screeners. [Online] Available at: http://www.phqscreeners.com/

Tyrer, P. (1984). Classification of anxiety. The British Journal of Psychiatry, 144(1), 78-83. DOI: 10.1192/bjp.144.1.78 PDF: https://www.researchgate.net/profile/Peter_Tyrer/publication/16504411_Classification_of_anxiety/links/54a52c1b0cf267bdb906ff78/Classification-of-anxiety.pdf

Tyrer, P., Owen, R. T., & Cicchetti, D. V. (1984). The brief scale for anxiety: a subdivision of the comprehensive psychopathological rating scale. Journal of Neurology, Neurosurgery, and Psychiatry, 47(9), 970–975. PMCID: PMC1028000 PDF: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1028000/pdf/jnnpsyc00125-0082.pdf

Zung, W. W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12(6), 371-379. DOI: 10.1016/S0033-3182(71)71479-0

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