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Internet-Based Acceptance and Commitment Therapy With Interoceptive Exposure for Panic Disorder: A Randomized
Lisa Bäckman1,2, Sandra Weineland1,3,4, Kristofer Vernmark5
1Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
Scandinavian Journal of Psychology
|November 29, 2025
Summary
An internet-based Acceptance and Commitment Therapy (IACT) program with interoceptive exposure effectively treats panic disorder. This approach shows promise for patients with concurrent agoraphobia, with significant symptom reduction observed.
Area of Science:
- Psychiatry and Behavioral Sciences
- Clinical Psychology
- Digital Health
Background:
- Panic disorder is a debilitating condition often co-occurring with agoraphobia.
- Traditional treatments may have limitations in accessibility and patient engagement.
- Internet-based interventions offer a scalable approach to mental healthcare.
Purpose of the Study:
- To evaluate the efficacy of an internet-based Acceptance and Commitment Therapy (IACT) program modified with interoceptive exposure for panic disorder.
- To assess the effectiveness of this IACT program in patients with or without concurrent agoraphobia.
- To explore the relationship between working alliances and treatment outcomes.
Main Methods:
- A randomized controlled trial involving 79 participants over 10 weeks.
- Comparison between an IACT treatment group and a waitlist control group.
- Assessment of panic disorder symptoms, diagnostic criteria, quality of life, and therapist/client-rated working alliances.
Main Results:
- Significant treatment effects on panic disorder symptoms (d=0.92) were observed in the IACT group compared to the control.
- 43% of participants no longer met diagnostic criteria post-treatment.
- Patients with concurrent agoraphobia showed large treatment effects (d=1.22) despite higher initial symptom severity.
- Therapist-rated working alliance, but not client-rated, correlated with treatment outcomes.
Conclusions:
- Interoceptive exposure-modified IACT is an effective treatment for panic disorder.
- This intervention demonstrates significant promise for individuals with concurrent agoraphobia.
- Therapist-client working alliance quality is a relevant factor in treatment success.
Keywords:
acceptance and commitment therapyagoraphobiacognitive behavioral therapyinternet‐basedinteroceptive exposurepanic disorderworking allianceMore Related Videos
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