Videoconferencing Cognitive Behavioral Therapy for Panic Disorder in an Emergency Room in Mexico: A Multiple Baseline...

The aim of this study was to evaluate the effectiveness of a brief cognitive behavioral therapy intervention conducted via videoconference for adults with panic disorder and agoraphobia in the emergency room (ER) of a Mexican hospital. We examined the impact of the intervention on quality of life, emergency room utilization, and participants' satisfaction with the intervention and the use of telepsychology. A multiple-baseline single-case experimental design was employed. Sixteen adults diagnosed with panic disorder were assigned to one of four cohorts and received seven individual therapy sessions each. They completed interviews, self-reports, and questionnaires before, during, and after treatment and at one-, three-, six-, and 12-month follow-ups. To estimate effect size for panic disorder severity, we calculated the nonoverlap of all pairs. We calculated an objective clinical change index for other outcomes. The intervention resulted in small to moderate effect on panic disorder severity, corresponding to a range between 0.27 and 0.91 of the nonoverlap of all pairs. After treatment, seven of the 12 participants who completed the intervention no longer met diagnostic criteria for panic disorder. Improvement in quality of life met objective our clinical change threshold for 33% of the participants. ER utilization decreased posttreatment and was maintained at 12 months (from up to 10 consultations prior to surgery to 0 consultations one year later). Most participants expressed satisfaction with the intervention and the use of telepsychology. Videoconferencing offered an accessible and effective avenue for intervention for adults with panic disorder and may relieve overcrowding in emergency departments. Future studies should continue to evaluate the effectiveness and multiple potential benefits of digital interventions in emergency rooms.