Treatment for Panic Disorder

Overcoming Panic Attacks & Agoraphobia

At the CTSA we are committed to providing empirically-supported treatments. In other words, the treatments that we use have been shown, through careful research, to work for many, if not most, people. Our treatment for Panic Disorder is based mainly on manuals by David Spiegel and Sandra Baker (2000) and research by Michael Telch and colleagues (e.g. Telch, Lucas, Schmidt, Hanna, Jaimez, & Lucas, 1992).

Treatment normally lasts between 10 and 20 sessions, but the exact number of sessions depends on each individual case.

In this treatment we aim to address and treat three main aspects of panic disorder that serve to keep its symptoms going:

1. Unrealistic thoughts or beliefs about the negative consequences of panic attacks
2. Fear of bodily sensations that have become automatic or "conditioned"
3. Avoidance of tasks and situations due to the fear that one might have a panic attack or panic-like symptoms.

What's involved in the treatment?

Psychoeducation. Education about the physical and psychological of causes panic attacks and panic disorder.

Breathing Retraining: education about how slow, diaphragmatic breathing can help prevent anxiety and panic in certain situations.

Exposure to fear bodily sensations. The therapist will help the patient find ways to bring on physical sensations that may cause a panic attack for the patient. The therapist will help the patient face these sensations and any panic symptoms that they cause and let them "ride their course" rather than trying to avoid or push away the anxiety. Eventually, these sensations will become less anxiety-provoking.

Exposure to feared situations. The therapist will help the patient face situations that they have become afraid of and "ride the anxiety out" rather than trying to run away from the situation. They will start from less feared situations, and move their way up a ladder, or "hierarchy" to more feared situations. As they go, these situations will become less and less anxiety-provoking.

Changing uphelpful, negative thoughts. The therapist will help the patient counteract catastrophic thinking, and to stop themselves from overestimating the likelihood of feared events or consequences.

Links and Resources

• Britain's National Health Service "Choices" Program Dr. Paul Salkovskis discussing panic disorder and its treatment
• NIMH Documentary about Panic Disorder and CBT Treatment
• Michael J. Telch's Cognitive Behavioral Group Treatment for Panic Disorder
• Nature and Causes of Panic by Mark Powers et al. (Dutch version)