Assessment: Accurately Diagnose Panic and Anxiety Disorders
- Panic disorder vs. panic attacks that are secondary to other anxiety disorders
- Psychosocial factors that may exacerbate panic symptoms
- Impact on client’s social and occupational functioning
- Is the client’s support system inadvertently reinforcing panic symptoms?
INTEGRATING ACT, CBT, & MINDFULNESS INTO YOUR THERAPEUTIC TOOLBOX
Psychoeducation: The Essential Foundation of Anxiety Treatment
- Teach clients about the physiology of fearand avoidance in a non-pathologizing manner
- When the body is behaving normally, just at the wrong time!
- Physical sensations that comprise a panic attack
- How short-term relief (avoidance, distraction, etc) isn’t enough to yield long-term wellness
- Teach clients ‘the why’ of exposure before going through it
Cognitive Behavior Therapy (CBT): Target Cognitive Distortions that are Common in Anxiety
- Catastrophizing, jumping to conclusions, tunnel vision, emotional reasoning, and overgeneralization
- Tools to help clients gain awareness of and reframe distorted thinking
- Disrupt the link between thoughts and unhelpful/avoidance/escape behaviors
- Help clients critically examine the beliefs they hold about panic and its aftermath
Exposure Techniques: Breaking the Anxiety and Panic Cycle
- The importance of client buy-in for exposure to be effective
- How to develop graduated exposure plan
- Subjective Units of Distress (SUDs) ratings to improve clinician-client communication
- In-vivo vs. imaginal exposure
- The importance of remaining in an exposure exercise until fear subsides
- Modify exposure for telehealth
Acceptance and Commitment Therapy (ACT): Teaching Clients to “Drop the Rope”
- Values clarification
- Use of metaphors
- Exercises to increase comfort with difficult emotions and sensations
Tools for Calming the Body in the Midst of Panic
- Breathing skills to interrupt worry thoughts and slow down physiological panic symptoms
- Relaxation techniques to reduce vulnerability to panic
- Grounding techniques to lower the intensity
- How a daily mindfulness practice can reduce panic
Recovery Maintenance Tools: Make Sure Therapy is Working and Help Clients Stay on Track
- Individualized methods of tracking success and challenges
- Help clients maintain consistent skills practice and reduce avoidance behaviors
- Maintain a panic attack progress tracking tool
- Connect treatment to client’s goals and values
Other Clinical Considerations
- Anxiety and panic during challenging times
- Increased anxiety rates during public health crisis
- Complicating factors of hypochondriasis and panic disorder
- Limitations of the research and potential risks