Facilitating Psychological Intervention for a Patient with Unilateral Vestibular Hypofunction

Abstract

Background and Purpose: Patients with vestibular dysfunction often have concurrent anxiety. Although physical therapists are not licensed to evaluate or treat anxiety, they can be alert to signs and symptoms of anxiety and facilitate referral to the appropriate practitioner. The purpose of this case report is to describe how clinicians can recognize psychological symptoms and to provide a model for facilitating psychological intervention that includes the use of screening tools to assist in determining the need for psychological referral. Case Description: The patient was a 49‐year‐old man with a diagnosis of unilateral vestibular hypofunction and signs of a developing anxiety disorder that included the use of anti‐anxiety medication and selfimposed limitations in leaving the home environment, in exercising, and in driving at work. The efforts of the physical therapist in identifying signs and symptoms of anxiety and in facilitating the patient's acceptance of a psychological referral are discussed. Outcomes: After physical therapy intervention there was a decrease in the physical symptoms of dizziness. In addition, after receiving education from the physical therapist, the patient initiated concurrent psychological treatment. Discussion: The high incidence of concurrent anxiety disorders for patients with vestibular dysfunction is an important modifier for the plan of care. Specific suggestions based on the model are offered for facilitating psychological referral.