Who this is for
Adults with mild-to-moderate generalized anxiety or chronic stress. GAD-7 >=15 with panic, OCD features, or severe avoidance routed to LCSW co-management. Active substance use disorder routed to SUD Pathway first.
What brings people here
GAD-7 >=10 on FMA; PSS-10 >=20; self-report chronic stress, worry, panic; HR referral after PTO crisis; FMA Stress & Resilience domain elevated.
Clinical framework
OneVillage-developed; evidence-based (GAD-7, PSS-10).
How the 8 weeks run
Baseline assessments, your first SMART goal, and the 1:1 that sets up everything after it.
Specialist coaches rotate in, and sessions come thickest here. One change at a time, in the domains your baseline flagged.
Re-score, refresh the care plan, and check in 1:1 on what is and is not working.
The remaining domains, at a lighter cadence, and the work of making the early weeks hold under pressure.
Final re-score, relapse prevention, and the plan for what happens next.
When your sessions fall
The program is built in four-week modules. Sessions come thickest at the start, when what you decide matters most, and step down as things settle. That is 5 sessions of 45 minutes across 8 weeks, counting the visit before week 1.
| Module | Weeks | Sessions | Cadence |
|---|---|---|---|
| Module 1 | Weeks 1 to 4 | 2 | every other week |
| Module 2 | Weeks 5 to 8 | 2 | every other week |
Week by week
- Before you beginBefore you begin
This is the reading before your first visit. It explains the two scores this pathway runs on, what a coach can help with, and the point at which the answer stops being coaching and becomes a licensed clinician.
- Week 1How anxiety keeps itself going
The most useful thing to understand this week is that anxiety is maintained by what you do about it. The dread produces an action, usually avoiding something or checking something, and the relief that follows teaches your nervous system that the action was necessary.
- Week 2Tools you rehearse before you need them
This week you meet Lucy Paulise, your stress management coach, for 45 minutes. The point of the session is not to feel calm during it. It is to leave with two or three specific techniques rehearsed often enough that they are available on a bad day, when learning anything new is impossible.
- Week 3Movement as an anxiolytic
Exercise is offered to anxious people so often and so glibly that it is easy to dismiss. The evidence is better than the delivery. It is also not a reason to leave a treatable anxiety disorder untreated.
- Week 4Halfway, and the medication conversation
This week you see Cindy Cathcart again for 45 minutes and complete the same GAD-7 and PSS-10 you completed at week 0. A midpoint exists to catch a plan that is not working while there is still time to change it.
- Week 5Caffeine, alcohol and blood sugar
Some of what you are calling anxiety this week is chemistry you administered yourself this morning. That is not a criticism, and it is not the whole story. It is the cheapest variable in this pathway to test.
- Week 6The sleep and anxiety loop
This week you meet Kelly Day O'Brien, NBC-HWC, your sleep coach, for 45 minutes. Anxiety and insomnia feed each other so directly that treating either one alone tends to leave the loop intact.
- Week 7The life anxiety has been shrinking
Go back to the list of three avoided situations you wrote in week 0. This week is about that list, because it is the most accurate measure in this pathway and the one a questionnaire does not capture.
- Week 8Making it hold
This is the last session with Cindy, 45 minutes, and it is a handover rather than a finish. Anxiety tends to come back under load, and the plan that matters most is the one for the weeks after this document.
Who you will work with
Your Whole Health Coach takes your first visit and closes every module, so it is the same person from the first session to the last. The specialists below lead the weeks where their work is the focus.
Professionally, Cindy has been a clinical nurse for nearly a decade. She served in both clinical and administrative capacities throughout her career and holds a Master's degree in Nursing Leadership. As a staff nurse, nurse leader, and quality improvement specialist, she led multidisciplinary teams in academic medical settings throughout Boston, New York, and Ohio to deliver high-quality care to patients across complex diagnoses.
Meet Lucy Paulise, who is a career and stress management coach, book writer, and Forbes contributor. Her passion lies in helping people discover and reach their full potential. She specializes in coaching individuals on how to manage stress, anxiety, imposter syndrome, perfectionism, or any other challenges they may face in their work or personal lives that can lead to feeling overwhelmed.
Kelly is a sleep behavior expert who connects to clients with genuine curiosity and compassion to unlock their potential for positive change. Sleep is a universal need AND is completely unique to the individual. No two sleep profiles are the same and Kelly uses multi-faceted and science-based approaches to support an understanding of the client’s desired outcome.
What we work on
| Domain | What this pathway does |
|---|---|
| Nutrition & Metabolism | Caffeine <300mg/day; alcohol within limits; stable blood sugar (protein + fiber breakfast). |
| Movement & Mobility | Aerobic exercise as anxiolytic. 150 min/wk MVPA. Avoidance pattern = LCSW conversation. |
| Sleep & Recovery | Sleep + anxiety loop is central. Sleep regularization first. |
| Stress & Resilience | GAD-7 + PSS-10 tracked. Daily relaxation practice. Breathwork tools rehearsed. |
| Mind & Mood | PHQ-9 monitored. Mixed anxiety + depression common. |
| Relationships & Purpose | Connection is protective. Schedule one social touch per week. |
How progress is measured
These are the validated tools this pathway uses: at your first visit, at the mid-program review, and at the end.
| Tool | Cadence | Owned by |
|---|---|---|
| GAD-7 | Onboard, every 2 weeks during Build, q4 weeks Maintain | WHC |
| PSS-10 | Onboard, q4 weeks | Stress Coach |
| PHQ-9 | Onboard, q4 weeks | WHC |
| AUDIT/DAST | Onboard, quarterly | WHC |
| ISI | Onboard, q4 weeks | Sleep Coach |
| Activity log | Weekly | Exercise Coach |
The research behind this pathway
Your clinician playbook was built from the guidelines and studies below. They are listed so you can read them yourself: every one is a real, published paper and the number at the end of each line is its PubMed ID.
Guidelines this pathway follows
- GAD-7 and PSS-10 · Spitzer and colleagues; Cohen and colleagues
The two validated measures this pathway repeats. PMID 16717171
- Cognitive behavioral therapy for anxiety · Meta-analysis of placebo-controlled trials
The evidence base for what the sessions teach. PMID 29451967
Key studies
- Cohen S et al. (1983). J Health Soc BehavA global measure of perceived stress
Introduced the Perceived Stress Scale, the measure this pathway repeats so you can see whether your stress is actually moving. PMID 6668417
- Spitzer RL et al. (2006). Arch Intern MedA brief measure for assessing generalized anxiety disorder: the GAD-7
Developed and validated the GAD-7, the seven-question anxiety measure used here. PMID 16717171
- Carpenter JK et al. (2018). Depress AnxietyCognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials
Pooled 41 placebo-controlled trials of cognitive behavioral therapy for anxiety disorders and found moderate to large effects across the conditions tested. PMID 29451967
- Goyal M et al. (2014). JAMA Intern MedMeditation programs for psychological stress and well-being: a systematic review and meta-analysis
Reviewed 47 trials and 3,515 people. Mindfulness meditation produced moderate improvements in anxiety, depression and pain, and the review is equally clear about what it did not show. PMID 24395196
- Gayed A et al. (2018). Occup Environ MedEffectiveness of training workplace managers to understand and support the mental health needs of employees: a systematic review and meta-analysis
Pooled trials of training managers to support employees' mental health. It is the evidence behind the workplace conversations this pathway helps you prepare for. PMID 29563195