Panic Control Treatment - Essay Example

Panic Control Treatment The DSM-IV distinguishes between several types of anxiety disorders; however, of significance to this research is Panic Disorder. A condition characterized by recurring unexpected panic attacks and the preoccupation with adverse consequences likely to result from the attacks (APA, 2000). Leskin and Sheikh (2004) estimated that 2.7% of the American population suffers from panic disorders. They inferred that women are 2.5 times more likely than men to suffer from Panic Disorder, and that its prevalence increases with age. Treatment of Panic Disorder either entails the use of psychotherapeutic interventions; however, extreme cases might require complementary psychopharmacological intervention (Plante, 2011). Cognitive Behavioral Therapy (CBT) proves to be the most efficient form of psychotherapeutic intervention for individuals diagnosed with panic disorder. CBT encompasses restructuring of negative thought patterns, beliefs by replacing them with more positive and realistic thoughts and beliefs respectively. Several types of CBT exist, of which all yield desirable outcomes in the treatment of Panic Disorder. Examined in this paper is the extent to which Barlow’s Panic Control Treatment (PCT) effectively treats Panic Disorder. Barlow and Craske’s initial intent for developing PCT centered on its use in the treatment of PD with limited agoraphobic avoidance. Since then, empirical validation of PCT has seen its use as the preferred treatment of PD and panic attacks linked to other psychological disorders such as schizophrenia or moderate to severe agoraphobia (Clark, 1999). PCT complements psychopharmacological treatment of severe psychosis or neurotic disorders. The ultimate goal of PCT encompasses fostering a patient’s ability to identify and rectify maladaptive thought patterns, beliefs and behaviors that trigger, maintain and exacerbate feelings of anxiousness, which in turn develop into full-blown attacks. Mental health practitioners achieve this goal by exposing patients afflicted with PD to sensations that mirror their panic attacks; for example, activities that fastens heart rate or arouses fear in the patient. They then follow the exposure therapy with a debriefing session whereby, they guide the patient through the exploratory phase aimed at uncovering attitudes and beliefs responsible for triggering panic attacks. The therapist strives to create awareness in the patient with the sole intention of empowering the patient to take charge over their disparaging fear resulting from negative thought, attitudes and beliefs. The final step of therapy entails equipping patients with coping skills customized to help reduce frequency in occurrence of panic attacks; for example, breathing and relaxation exercises (Clark, 1999). The efficacy of PCT rests on early diagnosis and the use of appropriate CBT and pharmacotherapy interventions. Since its development, the Task Force on Promotion and Dissemination of Psychological Procedures of the American Psychological Association, Division of Clinical Psychology has ran rigorous appraisals aimed at identifying whether PCT is a “well-established” therapeutic intervention for Panic Disorder. The first criterion met entailed the assessment of results from two clinical trials designed to appraise the success rate of treatment. Barlow and Craske reported that 80% of the patients diagnosed with PD remained panic free post-treatment, which was a high rate compared to the 40% assigned to the applied relaxation group and the 30% in the waitlist group who were panic free post-treatment (Barlow & Craske, 2007). Klosko et al (1995) and Telch et al (1993) replicated their study and confirmed the results. The second criterion entailed comparing pharmacotherapy interventions with PCT in order to determine, which yields lasting desirable results (Clark et al, 2000). Shear et al (1998) compared PCT with the usage of imipramine in the treatment of PD and found the former maintained infrequency of panic attacks (Clark et al, 2000). Majority of the studies done on the efficacy of PCT focused on samples primarily diagnosed with Panic Disorder and were either using or not using prescription medication for relieving anxiety. Currently, many studies on special populations are underway; for example, discontinued use of anxiety reliving medicine in patients diagnosed with PD and PD patients with co-morbid disorders such as schizophrenia. Recent research findings revealed that using PCT concurrently with the tapering of addictive anxiolytics such as benzodiazepine resulted in reduced relapse cases. For example, a study done by Spiegel et al in 1998 revealed that 90% of the patients suffering from PD did not relapse after six months of withdrawing from the use of alprazolam whereas, 80% of their counterparts who did not seek therapeutic intervention relapsed. Conversely, a 1999 study by Arlow et al reveled that eight of the 11 patients diagnosed with schizophrenia and PD benefited from the 16-week long group CBT, which functioned to reduce frequency of panic attacks and resulting functional interference. Despite the effectiveness of PCT in yielding successful results in the treatment of PD, researchers allude to some limitations. Firstly, very few studies exist detailing the outcome of PCT in patients suffering from severe agoraphobia (Sánchez-Meca et al, 2010). Secondly, majority of the studies done on the success of PCT involve the use of data from cross-sectional assessment whereby, the disregard for longitudinal assessment invalidates findings, as the latter reveal that the post-treatment course is marred by fluctuations and symptom recrudescence. This indicates that there is room for improvement. Finally, generalizability of results from studies done on concurrent use of pharmacotherapies and PCT is difficult because majority of the previous comparative studies used older medications, which the Food and Drug Administration (FDA) banned in favor of less addictive anxiolytics. In conclusion, PCT is a brief, structured variation of CBT developed by Barlow and Craske for the treatment of Panic Disorder. However, its use is not solely limited to the treatment of PD whereby, its combination with situational exposure modules validates its treatment of agoraphobia. PCT lasts for 12 weeks, after which, therapists provide follow-up services with the purpose of monitoring progress. More often than not, patients revert to normal life after the completion of therapy; however, minor symptom fluctuations might appear. In such cases, therapists offer relapse counseling. Despite the high prevalence of Panic Disorder, many individuals afflicted by the condition refrain from seeking proper interventions. The few who seek help from therapists receive psychosocial treatments instead of a variation of CBT (Simos & Hoffman, 2013). However, factors such as training and publication of effective therapeutic interventions help to mitigate this problem. References APA. The Diagnostic Statistical Manual TR-IV. New York: American Psychological Association, 2000. Print. Blackburn, I.-M., & Twaddle, V. (2011). Cognitive Therapy in Action: A Practitioners Casebook. New York: Souvenir Press. Clark, D. M. (1999 ). Anxiety Disorders: Why They Persist and How to Treat Them. London: Elsevier Science Ltd. Clark, D. M., Salkovskis, P. M., Hackmann, A., Wells, A., Ludgate, J., & Gelder, M. (1999). Brief Cognitive Therapy for Panic Disorder A Randomized Controlled Trial . Journal of Consulting and Clinical Psychology, 67(4), 583-589. Clark, D.M. and Salkovskis P.M. (2000) Panic Disorder in Hawton, K., Salkovskis, P.M., Kirk, J. & Clark, D.M. (Eds). Cognitive Behaviour Therapy: A Practical Guide (2nd Edition). Oxford: Oxford University Press. Craske M.G. and Barlow D.H. (2007) Mastery of your anxiety and panic (Therapist guide) 4th edition) Oxford: Oxford University Press Plante, T. G. (2011). Contemporary Clinical Psychology. New York: John Wiley & Sons. Sánchez-Meca, J., Rosa-Alcázar, A. I., Marín-Martínez, F., & Gómez-Conesa, A. (2010). Psychological treatment of panic disorder with or without agoraphobia:A Meta-Analysis. Clinical Psychology Review, 30, 37-50. Sheikh, J. I. and Leskin, G. "Gender Differences in Panic Disorder." 01 January 2004. Psychiatric Times. 03 May 2014. . Simos, G., & Hofmann, S. G. (2013). CBT For Anxiety Disorders: A Practitioner Book. New York: John Wiley & Sons. Read More