Evaluating the effectiveness of a focused CBT training for panic disorder: a randomized parallel trial

Recovery rates for panic disorder in NHS Talking Therapies (NHSTT) services in the United Kingdom do not match those in randomized trials. Previous research has found that training therapists in 'focused cognitive behavioral therapy' (CBT) improves outcomes. The primary aim was to examine whether focused CBT delivered by trained psychological well-being practitioners (PWPs) can improve treatment outcomes for panic disorder. An exploratory aim was to evaluate the potential impact of a novel component of focused CBT, which includes the use of 'approach-supporting behaviors' (ASBs) where safety-seeking behaviors (SSBs) are prominent.

We conducted a randomized parallel trial. Participants were randomly allocated to focused CBT or the current treatment at 'Step Two' (treatment as usual) in two NHSTT services (ISRCTN:11268881).

We found a significant group-timepoint interaction. Those in focused CBT had significantly greater reductions in the primary measure of panic severity relative to those in treatment as usual (TAU). The level of ASBs did not predict a change in panic severity; however, the level of SSBs at the end of treatment did predict a change in panic severity.

Focused CBT is effective for panic disorder and is superior to TAU, supporting the applicability of this lower-intensity and panic-specific version of CBT for panic disorder.