Processes of therapeutic change: Results from the Cornell-Penn Study of Psychotherapies for Panic Disorder

To examine process of changes in two distinct psychotherapies-cognitive-behavioral therapy (CBT) and Panic-Focused Psychodynamic Psychotherapy (PFPP). Two hypothesized processes of change-misinterpretation of bodily sensations and Panic Specific Reflective Function (PSRF)-were tested in the CBT and PFPP arms of the Cornell-Penn Study of Psychotherapies for Panic Disorder. The Brief Bodily Sensations Interpretation Questionnaire (BBSIQ) measures misinterpretation of bodily sensations-a focus of CBT interventions. PSRF, a target of PFPP, assesses the capacity to reflect on the underlying meaning of panic symptoms. A sample of 138 patients (37.7% men, 72.56% Whites, and 16.7% Latinx) with primary Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) panic disorder were included in the present analyses. Mixed effects models tested the effects of early change in BBSIQ and PSRF (intake through Week 5) on subsequent change in the Panic Disorder Severity Scale (PDSS; Week 5 through termination). Early change on both PSRF and BBSIQ predicted subsequent change in panic severity across the two treatments. As predicted, PSRF changed more in PFPP than in CBT, but, contrary to expectation, BBSIQ showed comparable changes in both groups. Counterintuitively, CBT patients benefited more in terms of panic symptom improvement when their PSRF improved than did PFPP patients. This is the first demonstration of general processes of change (PSRF and BBSIQ) across psychotherapies for panic disorder, suggesting that to the extent patients change their beliefs about the meaning of panic, their panic symptoms improve in time-limited, panic-focused psychotherapies. (PsycINFO Database Record (c) 2020 APA, all rights reserved).