Coping Skills and Exposure Therapy in Panic Disorder and Agoraphobia: Latest Advances and Future Directions

Summary & key facts

This review examines whether teaching coping skills (like changing thoughts, breathing, or relaxation) makes exposure therapy work better for panic disorder and agoraphobia. Panic disorder affects about 4.7% of people in the U.S., and while CBT (which centers on exposure plus coping skills) helps, many patients remain symptomatic — for example, one large trial found only 32% of people given CBT alone had a strong response 12 months after treatment. The authors conclude that current studies give little clear evidence that adding traditional coping skills boosts exposure, and they note that most studies measure whether skills were taught rather than whether patients actually learned or used th

Key facts:

• Panic disorder with or without agoraphobia has an estimated lifetime prevalence of about 4.7% in the United States (Kessler et al., 2005).
• Cognitive-behavioral therapy (CBT) is the most empirically supported psychosocial treatment for panic disorder and agoraphobia, but effect sizes are smaller for panic than for some other anxiety disorders and many patients remain symptomati
• In the largest randomized controlled trial cited, only 32% of patients assigned to CBT alone showed a strong treatment response 12 months after acute treatment (Barlow et al., 2000).
• Traditional coping skills discussed include cognitive restructuring (changing catastrophic thoughts) and behavioral skills such as breathing retraining and relaxation.
• Most studies that compared cognitive training (CT) plus exposure versus exposure alone found no clear added benefit from CT; CT plus exposure typically did not outperform exposure by itself.
• A major limitation of the existing research is that studies generally test whether coping skills were delivered, but do not reliably measure whether patients actually acquired the skills or applied them during exposure therapy; this limits

Topics

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Child and Adolescent Psychosocial and Emotional Development Mental Health Research Topics

Categories

Experimental and Cognitive Psychology Psychology Social Sciences

Tags

Agoraphobia Anxiety Biology Clinical psychology Cognition Cognitive therapy Coping (psychology) Evolutionary biology Exposure therapy Extant taxon Panic Panic disorder Psychiatry Psychology Psychotherapist

Conditions & symptoms

Anxiety Panic disorder and phobias Panic