Panic is a complicated and debilitating psychological condition. Some people experience symptoms of agoraphobia, which further exacerbate their panic. The negative consequences of panic include increased terror, fear, and anxiety. People who have panic and agoraphobia may also have increased heart rate, agitation, and stress, which all coalesce to decrease overall physical and mental health. In fact, many individuals with panic and phobia have a significantly impaired quality of life due to the social limits they encounter.
Various treatments exist for panic, including psychotropic medication and behavioral therapies. To date, cognitive behavioral therapy (CBT) has been shown to be far more effective at preventing relapse and decreasing symptoms of panic than medication. However, when medication and CBT are stopped, neither seems to provide a more protective shield from eventual relapse in the long run. Therefore, Kamila S. White of the Department of Psychology at the University of Missouri thought that perhaps a maintenance treatment would help buffer clients from the negative effects of treatment termination and possible relapse.
In a recent study, White followed 379 participants with panic, some of whom had agoraphobia as well, after they completed 3 months of CBT. Half of the participants continued with 9 more months of maintenance CBT (M-CBT) and assessments, while the remaining half had 9 months of assessments only. Following that, White evaluated the participants for 12 more months and found a significant difference in relapse vulnerability between the two groups. Those in the M-CBT had a 5.2% relapse rate, while those who only had assessments had a nearly 20% relapse rate. The level of agoraphobic symptoms reported at the end of the initial three months of CBT was also associated with the length of time to relapse for the participants.
The researchers found that maintenance treatment is not only essential to sustain gains made in acute treatment, but it can also significantly reduce symptom severity in people with panic, whether they have agoraphobia or not. White added that although the M-CBT provided lasted 9 months in her study, it is possible that shorter treatment periods may be equally beneficial. “For now,” she said, “a reasonable clinical strategy would indicate continuing maintenance treatment until agoraphobia as well as panic disorder symptoms are no more than minimal in a given patient.”
White, K. S., Payne, L. A., Gorman, J. M., Shear, M. K., Woods, S. W., Saksa, J. R., and Barlow, D. H. (2012). Does maintenance CBT contribute to long-term treatment response of panic disorder with or without agoraphobia? A randomized controlled clinical trial. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0030666
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