The primary goal of treatment for adjustment disorder is to relieve symptoms and to help an individual achieve a level of functioning comparable to what they demonstrated prior to the stressful event. This patient is a wealthy, older man who suffers a heart attack and is forced to step down from an executive position. A preliminary investigation of acceptance and commitment therapy for adolescent obsessive-compulsive disorder. The extreme response may be linked to a single eventa flood or fire, In addition to its common symptoms of depression, anxiety, or reckless behavior, adjustment disorder is also associated with an increased risk of, norm-violating or inappropriate conduct (getting into fights, driving recklessly, etc. In general, these goals should be realistic they should be reasonable, given the clients general experience and hopes for the future. Peer group therapy. What are the risk factors for the treatment of adjustment disorders? Adjustment disorder with depressed mood: A child may exhibit crying spells, loss of interest in usual activities, feelings of hopelessness, and increased sadness. A great compact refresher! The symptoms also must not represent normal, Adjustment disorder is caused by one or more life stressors. While treatment plans are quite popular in mental health treatment, it should be noted that not every therapist or clinician will use one. All Rights Reserved. Start your healing journey with people equipped with skill and compassion to help you. Adjustment disorders. Goals and objectives will vary tremendously from one person to the next, especially those facing very different problems. Treatments for adjustment disorders include psychotherapy, medications or both. Realizing the urgency of the situation, she seeks therapy. child adjustment disorder treatment plan goals and objectives . TREATMENT PLAN FOR ADOLESCENT DEPRESSION The Adolescent Psychotherapy Treatment Planner . >!-7H+0LQNE%-hB@7Z0[cJ4@j\G[3s G}7mP8^N,E! adjustment disorder. Remain hopeful about the future and strive for a positive attitude. A therapist may even use these tools following the conclusion of a clients in-person treatment as part of a follow-up, such as to assess whether a client has remained psychologically well a few months down the line or requires additional support. Are the interventions SMART (Locke & Latham, 1990)? Treatment will depend on your You can do these things to help your child: Call your childs healthcare provider if your child has: Tips to help you get the most from a visit to your childs healthcare provider: Cedars-Sinai has a range of comprehensive treatment options. You can do these things to help your child: Keep all appointments with your childs healthcare provider. Here is another example. needs and how serious the adjustment disorder is. Know why a test or procedure is recommended and what the results could mean. There are 6 subtypes. HOO &Df\[mNi>8gNg&%)PBQz7l1o WWd>vk-;/)i If your child is having difficulty adjusting, try gently encouraging your child to talk about what he or she is going through. unhealthy emotional or behavioral reaction to a stressful event or change in a persons endstream endobj startxref They are based on the type of major symptoms a child may feel. Keep all appointments with your r;--EV,+J5=(US0.HaNC;@e DAxQpYds Do you drink alcohol or use recreational drugs? endstream endobj 663 0 obj<>/Metadata 27 0 R/PieceInfo<>>>/Pages 26 0 R/PageLayout/OneColumn/StructTreeRoot 29 0 R/Type/Catalog/LastModified(D:20080527151232)/PageLabels 24 0 R>> endobj 664 0 obj<>/ProcSet[/PDF/Text]/ExtGState<>>>/Type/Page>> endobj 665 0 obj<> endobj 666 0 obj<> endobj 667 0 obj<> endobj 668 0 obj<> endobj 669 0 obj<> endobj 670 0 obj<> endobj 671 0 obj<> endobj 672 0 obj<> endobj 673 0 obj<> endobj 674 0 obj<>stream Employers and/or employees (Croft, 2015). Taking these steps can enhance a childs normal growth and development. treatment goals for adjustment disorder Adjustment disorder involves the development of emotional or behavioral symptoms in response to an identifiable stressor (or stressors) occurring within three months of the onset of the stressor and lasting no longer than six months after the stressor has ended. Adjustment disorder, sometimes referred to as situational. life. may get care from a team that may include counselors, therapists, social workers, 0000003747 00000 n 430 0 obj <> endobj Some events that may Adjustment disorder involves the development of emotional or behavioral symptoms in response to an identifiable stressor (or stressors) occurring within three months of the onset of the stressor. Treatment Contract the contract between the therapist and client that summarizes the goals of treatment. POOR SOCIAL SKILLS Goal: Client will improve social skills and increase support system. Be ready to answer them to reserve time to go over any points you want to focus on. According to the DSM-5, between 5 and 20 percent of those in outpatient mental health treatment can be diagnosed with adjustment disorder. download our three Positive Psychology Exercises for free, Technologies to Support Mental Health Treatment Plans (Incl. endstream endobj 657 0 obj<>/W[1 1 1]/Type/XRef/Index[37 608]>>stream Participant(s) Developing the Plan: Susan Lobao (Counselor) Mary Golden (Client) Diagnosis: Major depressive disorder, single episode, severe without psychotic features, F32.2 . They happen equally in boys and girls. He or she talks with you, Know what to expect if your child does not take the medicine or have the test or procedure. And [], Alfred Adler, a pivotal figure in the early development of psychotherapy, saw the importance of personal choice, cooperation, and connectedness in overcoming difficulties and making [], Psychodrama has been described as individual therapy in a group format, with action taking place around the protagonists multiple roles in life, such as a [], Chamber of Commerce (KvK) Registration Number: 64733564, 6229 HN Maastricht, 2023 PositivePsychology.com B.V. Development of a short readiness to change questionnaire for use in brief, opportunistic interventions among excessive drinkers. Fax: (949) 476-3080. Access ANCHOR, the intranet for Nationwide Childrens employees. Whether you start by seeing your primary care doctor or a mental health professional for evaluation and treatment, here's some guidance to help you prepare for your appointment, and what to expect from your doctor. improving the overall mental health of the child and parent. There are 6 subtypes. Know why a test or procedure is recommended and what the results could mean. Leahy, R. L., Holland, S. J., & McGinn, L. K. (2011). By filling out your name and email address below. Treatment plans are not necessarily required to give or receive successful treatment, but they can be extremely helpful in facilitating a smooth and hassle-free treatment experience. Thank you for such a comprehensive and well organized article which is especially helpful for those of us new MSWs just going out into the field. This field is for validation purposes and should be left unchanged. Significant impairment of social, occupational, or other important areas of functioning. Adjustment disorder in children is caused by stressful life events and/or rocky developmental transitions. Its not known how to prevent an adjustment disorder in a child. Where they are in their development and ability to deal with a stressor may also play a part in how they react. They will ask for a full history of your childs development, life events, emotions, behaviors, school performance, and the stressful event. Online Medical Reviewer: L Renee Watson MSN RNMarianne Fraser MSN RNPaul Ballas MD. Gabbard GO, ed. %PDF-1.4 % Your doctor may ask: Mayo Clinic does not endorse companies or products. Symptoms of adjustment disorder in children can relate to mood, behavior, or both and can include: Low mood, listlessness Withdrawal These symptoms may include: According to the DSM-5, the symptoms or behaviors must be clinically significant, typically evidenced by one or both of the following: The distress or impairment associated with adjustment disorders frequently manifests in decreased performance at work or school, or in temporary changes in social relationships. ACT aims to improve relationships clients have with internal experiences. Webber says the goals of CPP typically include: strengthening the attachment between the child and parent. <<7d1766f657b4174a81c848311d6e9de1>]>> Reach out for support from local And third, she learns how to select more suitable romantic partners (to reduce the likelihood of future breakups). Also know what the side effects are. Taking these steps can enhance a childs normal growth and development. Before your visit, write down questions you want answered. A treatment plan does many things, the most important of which include (Leahy, Holland, & McGinn, 2011; PHN, 2017): This documentation of the most important components of treatment helps the therapist and client stay on the same page, provides an opportunity for discussion of the treatment as planned, and can act as a reminder and motivational tool. How soon do you expect my symptoms to improve? If you have any updates, please do contact me in my below contact details. However, if youre looking for support, perhaps get in touch with the International Board for Certification of Group Psychotherapists, who offer customized training and consultations on these sorts of topics. . Our Global Patient Services team is here to help international and out-of-area families every step of the way. Advertising revenue supports our not-for-profit mission. Some events that may lead to this problem in a child or teen are: Death of a parent, sibling, grandparent, or other significant person, A sudden sickness in the child or a family member, A long-lasting (chronic) illness in the child or a family member. Adjustment disorders are among the most prevalent psychiatric conditions. In all adjustment disorders, the reaction to the stressor seems to be more than what is thought to be normal. DIAGNOSTIC SUGGESTIONS: Axis I: 309.24 Adjustment Disorder With Anxiety 300.02 Generalized Anxiety Disorder 314.01 Attention Deficit / Hyperactivity Disorder, Combined Type . for adjustment disorder, treatment plan goals amp objectives eye of the storm inc, free download here pdfsdocuments2 com, mental health adjustment disorder webmd, cpp textbook o child and dolescent ental health introduction a, adjustment disorder treatment child mind institute, adjustment disorder symptoms psych central, I am Dr. Ahmer Mehkri, Health Manager in Shell Oil Company Saudi Arabia. 0000003174 00000 n Adjustment disorders are treated using both medications and psychotherapy, though research evidence for the effectiveness of psychotherapy is stronger. A child learns how to better solve problems, communicate, and handle stress. This reaction is disproportionate to the stressor and impairs daily functioning. Make a donation. This therapy develops social and interpersonal skills. For diagnosis of adjustment disorders, the DSM-5 lists these criteria: The DSM-5 lists six different types of adjustment disorders. TREATMENT PLAN FOR ADOLESCENT ANXIETY The Adolescent Psychotherapy Treatment Planner (2000), Arthur E. Jongsma Jr., et al., Wiley Pub. Individuals suffering from adjustment disorder should work to develop and maintain a healthy diet and sleep pattern, as well as a strong social support system. Thank you so much for your support. Your doctor will ask about your medical, mental health and social history. Unable to concentrate or pay attention to things of low interest, even when those things are important to his/her life. 0000005574 00000 n In short, they become more resilient. Let us know in the comments! Live a healthy lifestyle that includes good sleep, a healthy diet and regular physical activity. Feel free to rearrange, remove, and add as needed, but make sure to properly cite the source if you use it for profit or publish it somewhere (source information is at the bottom of the template). This is important if your child becomes ill and you have questions or need advice. Adjustment disorder with mixed anxiety and depressed mood: Symptoms are a combination of depression and anxiety. Medications are occasionally used to treat aspects of the disorder that mirror other symptoms of other disorders. xb```b`` ,` N``'rA!`8F6wU` j1(%u@2QA h Most people recover from adjustment disorder without any remaining symptoms if they have no previous history of mental illness and have access to stable social support. Individuals suffering from adjustment disorder should work to develop and maintain a healthy, Psychosis/Schizophrenia Spectrum Disorders. But spotting it early and getting expert help for your child can ease severe symptoms. Or the reaction greatly interferes with how the child functions day to day. These science-based exercises will explore fundamental aspects of positive psychology including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees. (2005). This item has been a blessing to me. Treatment selection is a clinical decision to be made with the treating clinician and the patient. In hospital psychiatric consultation populations, nearly half the patients meet the criteria for these conditions. 0000004316 00000 n 0 & When medication is used, it is almost always in addition to psychotherapy. Under what circumstances? trailer Personal, family, and group therapy can help. If your child has a follow-up appointment, write down the date, time, and purpose for that visit. For instance, a common goal for those struggling with substance abuse may be to quit using their drug of choice or alcohol, while a patient struggling with depression may set a goal to reduce their suicidal thoughts. Adjustment disorder with anxious mood: Symptoms of anxiety are dominant. The criteria for treatment of adjustment disorders include: The development of behavioral or emotional symptoms (e.g., worry, nervousness, depression) within three months of the occurrence of a stressor. Are there any brochures or other printed material that I can have? 0000007514 00000 n They happen in all cultures. It may include improving communication skills and family interactions. Typical treatment for adjustment disorder includes psychotherapy and may involve medication. Before you continue, we thought you might like to download our three Positive Psychology Exercises for free. In adults, these stressors are most commonly related to marital discord, finances, or problems at work. In: Gabbard's Treatments of Psychiatric Disorders. This content does not have an English version. Ask if your childs condition can be treated in other ways. can look like other health problems or mental illnesses. Tell others about your childs adjustment disorder. Treatment will depend on your childs symptoms, age, and health. Children and teens with adjustment disorders tend to display more negative behavioral symptoms, such as disobeying authority figures or getting into fights; they may also be more prone to physical symptoms such as stomachaches. Choose a doctor and schedule an appointment. Teamwork among doctors, parents, teachers, caregivers, other health care professionals, and the child. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. #84hE7U"{n5TBF)'3r;K9OjoRmuz{{)`Wjo6l_n9"T00`M:fCMQO?M$hia$Kb .kwXO^&/e=:#y^^t Is my condition likely temporary or long term? 0000008016 00000 n A treatment plan will include the patient or clients personal information, the diagnosis (or diagnoses, as is often the case with mental illness), a general outline of the treatment prescribed, and space to measure outcomes as the client progresses through treatment. The response happens within 3 months of the stressful event. 0000001018 00000 n Newport Beach CA 92660, Phone: (949) 887-7187 I have been looking how to Create a Treatment Plan, so here are many resources out there on how to create a mental health treatment plan, thanks so much. event. Has the clients stage of readiness to change been considered in the interventions (Rollnick, Heather, Gold, & Hall, 1992)? 0000005413 00000 n Follow-up activities. 2023 Cedars-Sinai. My goal is to share with you some social-emotional objectives to help you spend less time on documentation and more time doing whatever it is you want! Have your child see his or her An adjustment disorder is an Many parents assume that talking about a difficult change, such as divorce, will make a child feel worse. POSSIBLE TREATMENT PLAN GOALS AND OBJECTIVES FOR KIDS AND ADOLESCENTS (cont.) Family therapy. HWko_^7EbhhC Treatment plans facilitate easy and effective billing since all services rendered are documented. 0000001713 00000 n In in-hospital psychiatric settings, it is an even more common diagnosis, sometimes approaching 50 percent. Treatments for adjustment disorders include psychotherapy, medications or both. Or the reaction greatly interferes with how the child functions day to day. Arlington, Va.: American Psychiatric Association; 2014. http://www.psychiatryonline.org. https://www.hopkinsmedicine.org/health/conditions-and-diseases/adjustme, Gambling Disorder (Compulsive Gambling, Pathological Gambling), Hallucinogen Persisting Perception Disorder (HPPD), Sedative, Hypnotic, and Anxiolytic-Related Disorders, Substance/Medication-Induced Psychotic Disorder, Neurocognitive Disorders (Mild and Major), Attention-Deficit/Hyperactivity Disorder, Adult, Attention-Deficit/Hyperactivity Disorder, Children, Attention-Deficit/Hyperactivity Disorder, Teen, Disruptive Mood Dysregulation Disorder (Children and Adolescents), Intellectual Disability (Intellectual Developmental Disorder), Persistent Depressive Disorder (Dysthymia), Depersonalization / Derealization Disorder, Dissociative Identity Disorder (Multiple Personality Disorder), ARFID (Avoidant Restrictive Food Intake Disorder), Binge-Eating Disorder (Compulsive Overeating), Persistent (Chronic) Motor or Vocal Tic Disorder, Obsessive-Compulsive Personality Disorder, Psychotic Disorder Due to Another Medical Condition, Genito-Pelvic Pain or Penetration Disorder (Sexual Pain Disorder), Non-Rapid Eye Movement Sleep Arousal Disorders, Rapid Eye Movement Sleep Behavior Disorder, Factitious Disorder (Munchausen Syndrome). An adjustment disorder is an unhealthy emotional or behavioral reaction to a stressful event or change in a person's life. A wide range of people can benefit from mental health treatment plans, including: While people in similar circumstances with similar issues may have similar treatment plans, its important to understand that each treatment plan is unique. H|Ko0st "$ A."m4p}Wj 9qv* "sp5r\8N_8 Treatments for adjustment disorders must be tailored to the needs of the child, based on the child's age, health, and medical history (Medical Center of Central Georgia, 2002). Rollnick, S., Heather, N., Gold, R., & Hall, W. (1992). Anticipated completion date: 6-4-07 Short Term Goals/Objectives: 1. . I am just beginning to break new ground in the world of counseling. What is a mental health treatment plan? Make a plan to address problems when they occur, rather than avoid them. Goal 1: Ensure safety of the child Goal 4: Engage in trauma work if needed Objective 1: Assess caregiver's attitude towards and perceptions about the child Objective 2: Provide psychoeducation for caregivers Positive parenting and appropriate consequences Increase parental sensitivity and responsiveness to child's needs In therapy, the patient acquires the skills needed to cope more effectively with intense emotionsfor instance, expressing her pain verbally instead of through destructive behaviors like suicidal attempts. Its good to be on such platformshort, it helps in enhancing our skills as mental health service providers. Some events that may lead to this problem in a child or teen are: A family move Death of a parent, sibling, grandparent, or other significant person The goals of treatment for gender dysphoria all have to do with coming to terms with . xref Expertise. xbbd`b``3 1x4>w| American Psychological Association. He or she will ask for a full history of your childs Quenza), Examples of Mental Health Treatment Plans, International Board for Certification of Group Psychotherapists, Describing the treatment prescribed by the health/, Setting a timeline for treatment progress (whether its a vague timeline or includes specific milestones), Noting important milestones and objectives, People living with a serious mental illness, People experiencing distress in one or more areas of life, People experiencing sexual or gender identity issues. How To Support Someone With a Mental Health Problem. the school setting. What do you think is causing my symptoms? Psychotherapy Psychotherapy, also called talk therapy, is the main treatment for adjustment disorders. However, therapists are increasingly leveraging the benefits of technology in creative ways to help develop, execute, and evaluate mental health treatment plans using a blended care approach. Even in identical diagnoses in similar individuals, differences are bound to manifest in any or all of the following components: The therapist and client will work together to get this information down on paper, with the therapist contributing his or her expertise in treatments and treatment outcomes, and the client contributing expertise in his or her own life and experiences. However, the DSM-5 notes that individuals from disadvantaged circumstances tend to experience higher rates of stressors and may thus be at higher risk for adjustment disorders. Adjustment disorder with mixed disturbance of emotions and conduct. 0000004577 00000 n Although they're all related, each type has unique signs and symptoms. 0000001014 00000 n The symptoms also must not represent normal bereavement. Diagnosis of adjustment disorders is based on identification of major life stressors, your symptoms and how they impact your ability to function. Has the client (and significant others) participated in developing this treatment plan? At face value, executing all the components of a mental health treatment plan may seem like a lot to address in a series of fifty-minute therapy sessions. Plus, there are no wait times to join groups. They talk with you, your partner, and your child. Easily distracted and drawn from task at hand. Treatment will also include eliciting the patient's concern and helping the individual understand his or her role in the stressors, reviewing and reinforcing any positive steps the patient may have already taken to deal with the stressors, teaching additional ways to cope with or avoid future stressors, helping the individual put stressors in perspective to their life overall, helping the person better understand his or her reaction to the stressors, and helping the patient come to perceive stressors as an opportunity for positive change or improvement. G%r33g~$?80OWo 'Lfr9LsF8?Ney2_"W% , wKt\mYK_&?\\ . Journal of Cognitive . xQi!"[+pt"`j9T// _Evz~8o{8o!SWn*\XXtIqNpFg-WH!q& Psychotherapy, also called talk therapy, is the main treatment for adjustment disorders. 0 0000001212 00000 n Likewise, the plan may incorporate various psychoeducational interventions which can be delivered digitally, such as guided meditations, reflection exercises, or self-paced learning modules. 0000000016 00000 n Relaxation techniques might be explored to deal with feelings of stress. Target outcomes for behavior. These goals will often center around recognizing and taking advantage of the social supports available to an individual in the form of family, friends, and community. Children and teens differ in their personalities, past experiences, vulnerability, and coping skills. A mental health expert such as a Is this treatment plan individualized to fit the client based on their unique abilities. The reaction must occur within three months of the identified stressful event or change happening. http://www.heart.org/HEARTORG/HealthyLiving/StressManagement/FightStressWithHealthyHabits/Fight-Stress-with-Healthy-Habits_UCM_307992_Article.jsp#.WBeRM2dTHRE. <<4914781ED31CE84EB08934B8C97B322D>]>> Your child's adjustment disorder may significantly interfere with his or her ability to learn. When adjustment disorder persists, it may progress into a more severe condition such as major depressive disorder. Reduce the . Adjustment disorders can be: Many people with adjustment disorders find treatment helpful, and they often need only brief treatment. Work with your childs healthcare provider and school to create a treatment plan. Have you been having any problems at school or work? SMART goals help to ensure that the treatment being provided is clinically appropriate and meaningful to the member. Adjustment disorders are a reaction to stress. They are based on the type of major symptoms a child may feel. That's why the DSM 5 changed the name and criteria for diagnosis. Dear Courtney Ackerman, Thus, diagnosis usually requires a clinical interview that encompasses recent stressors, a history of mental health or medical issues, and the individual's current ability to function in day-to-day life. Know why a new medicine or treatment is prescribed and how it will help your child. These are the most common symptoms of each subtype: Adjustment disorder with depressed mood. learn. The next objective may be to make it to the neighborhood market, or up to 30 steps outside their front door. For example, an objective for an individual with extreme anxiety may be to take 10 steps outside their front door. Know what to expect if your child does not take the medicine or have the test or procedure. Some people, however, react to stressors much more intensely (e.g., with greater anxiety and depression) or experience more functional impairment (e.g., greater difficulties at work or school) than do others. A child has a mix of symptoms from all of the above subtypes. Have you ever created a mental health treatment plan? Adults with adjustment disorder, by contrast, tend to be more prone to depressive symptoms. Client will be able to interact with peers at an age appropriate level. Examples of psychological interventions include cognitive-behavioral therapy (CBT), interpersonal therapy, and brief psychotherapy. But spotting it early and getting expert help for your child can ease severe symptoms. Describe the signs and symp-toms of an adjustment disorder that are experienced and note their impact on daily life. providing both the child and . Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. In addition to its common symptoms of depression, anxiety, or reckless behavior, adjustment disorder is also associated with an increased risk of suicidal behavior and substance abuse, as well as the prolonging of medical disorders or interference with medical treatment. Arthur E. Jongsma Jr., et al., Wiley Pub. Have you made any impulsive decisions or engaged in reckless behavior that doesn't seem like you? This is important if your child becomes ill and you have questions or need advice. Knowing what you value will help you build the most meaningful life possible. The 2 Most Psychologically Incisive Films of 2022, The Surprising Role of Empathy in Traumatic Bonding. xref The road to resilience. :.@Ed>~ibc4pdpOE]a-TfE?0WESsH^%A`^"5Dw1J!V6pp8q0Mq{M2KoG`z"pBgs4p|PJ+(Q9 :h1a*@(z|#uTII%GYf5+-,F!H.8eyu$WCW)>K$U'A;N6$$[[HVI q NHPhRcO\EV5 Further, the stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a pre-existing disorder. hb```Na`0pL```xRN_O``hh``` BT@in [#Vjs_|` dX^QH3Q7d`T8yg ]NB 3 Responsibility a section on who is responsible for which components of treatment (client will be responsible for many, the therapist for others). But a child may need them for a short time if a certain symptom is severe. But the stressors and signs may vary based on cultural influences. %PDF-1.5 % A treatment plan was created or reviewed today, 9/22/2016, for Mary Golden. There are 6 subtypes of adjustment disorder. I would like to have a consultation if you can help me with this topic. Adults have more depressive symptoms. Sawchuk CN (expert opinion). Marked distress out of proportion to the severity or intensity of the stressor, taking into account the external context and cultural factors that might influence symptom severity and presentation. These individuals may develop a condition called an adjustment disorder. For example, using a blended care platform such as Quenza, a therapist may carry out some of the initial steps in the assessment/diagnosis phase of a treatment plan, such as by inviting the client to complete a digital diagnostic questionnaire. The response happens within 3 months of the stressful event. http://www.apa.org/helpcenter/road-resilience.aspx. Brainspotting Therapy What is it and How does it Work? 0000006467 00000 n Anxiety Disorder. > [Content_Types].xml ( OO0H|Wp@h.
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