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Treating Anxiety and Related Disorders | South Central MIRECC

A mental health provider talking with a patient

About An All-Encompassing Approach to Treating Anxiety and Related Disorders: A Safety Aid Reduction Treatment Manual (START)

This manual is designed to be used by clinicians who have experience delivering cognitive behavioral therapy (CBT). The manual provides implementation guidelines for this transdiagnostic treatment, which is designed to target various anxiety and related disorders via the identification and elimination of safety aids.

  • This treatment program consists of 10 weekly, group-based sessions, each lasting one hour.
  • The manual is divided into chapters, each corresponding to a treatment session. Each chapter includes a materials list, session outline, treatment information and techniques, as well as homework.
  • It will be important to monitor Veterans’ progress throughout treatment and share the results with them to assess their progress over time. This can be accomplished by having Veterans complete disorder- specific self-report measures at regular intervals in addition to the provided "Safety Behavior Assessment Form."
  • Given the importance of therapeutic rapport to treatment success, it will be essential to foster an environment in which the Veteran feels safe and respected.
  • Published 2021

This product is a best practice.


Developed By

Amanda M. Raines, PhD, Joseph W. Boffa, PhD, Jason T. Goodson, PhD, C. Laurel Franklin, PhD, and Norman B. Schmidt, PhD.

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Use of these Materials and Finding VA Health Care

Please note that the health care information provided in these materials is for educational purposes only. It does not replace the role of a medical practitioner for advice on care and treatment. If you are looking for professional medical care, find your local VA healthcare center by using the VA Facilities Locator & Directory. This page may contain links that will take you outside of the Department of Veterans Affairs website. VA does not endorse and is not responsible for the content of the linked websites.

Last updated: December 14, 2023