Cognitive behavioral techniques for the management of panic disorder
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Cognitive behavioral techniques for the management of panic disorder.
Per the scenario, the client is experiencing emotional responses such as anxiety, fear, and terror; behavioral responses includes hypervigilance and avoidance. With panic attacks, emotions and behaviors may misinterpret benign symptoms leading to the aforementioned responses (Curtiss et al., 2021). Various cognitive behavioral therapies (CBT) that may be efficacious in modulating these responses includes: Psychoeducation, relaxation training, mindfulness strategies, interoceptive and in vivo exposure, and cognitive restructuring (Curtiss et al., 2021, p. 217). Results have proven that for optimal outcome of panic disorder, exposure therapy is vital (Roy-Byrne & Craske, 2021).
Psychoeducation is a cognitive-behavioral treatment that relies on educating the patient in developing an awareness of thoughts and behaviors which may reinforce symptoms of panic disorder. Patients are taught to identify their behaviors and feelings associated with the symptoms of panic which basically preserves the condition. By understanding how these factors cycles the cognitive and behavioral responses; patients can have a better understanding on how to develop strategies to decrease or eliminate the symptoms (Curtiss et al., 2021).
Relaxation training which may include interventions that incorporate physically relaxing muscle groups in response to tension have shown that it targets the physiological symptoms experienced. One such technique is called progressive muscle relaxation (PMR). In the application of PMR, the provider instructs the patient to produce tension in a particular muscle such as a fist, followed by prolonged relaxation. Caution should be utilized when providing such psychotherapy as it may undo reduction of fear (Curtiss et al., 2021).
Mindfulness is a technique that employs the patient to utilize a nonreactive mentality by focusing on the present-moment. Meditation exercises utilize mindfulness by redirecting the patient from reactive responses which precipitates thoughts related to symptoms of panic. Mindfulness is best suited as a complimentary therapy with other CBT techniques (Curtiss et al., 2021).
Interoceptive exposures utilizes training the participant to reproduce physiological symptoms via simple benign exercises that may reproduce similar symptoms of a panic attack; these exercises are utilized to encourage the patient to participate in benign activities which will reproduce the feared physiological symptoms such as heart palpitations, shortness of breath, dizziness, etc.… Comparable exposures such as running in place may stimulate the comparative symptoms of stimulating heart palpitations. Exposures are utilized to stimulate the symptoms to a tolerable or beyond tolerable point; the clinician will defer from calming the patient as the goal is to promote tolerability and disruption of the feared physiological response (Curtiss et al., 2021).
In Vivo exposures is the technique of repeatedly exposing the patient to situations/environments that may be perceived as menacing. Commonly utilized for situations such as agoraphobia and claustrophobia; in vivo addresses the targeted situational fear. The goal of this type of therapy is to allow the patient to confront the environmental stimuli without retreating to behaviors of avoidance or utilizing supportive comfort measures i.e. distraction. Successful outcome of this technique is the subjective reports of decreased anxiety reported by the patient via the continued exposure (Curtiss et al., 2021).
Cognitive restructuring involves the process of training the patient to redefine the potential catastrophic thoughts that may signal further fear. Cognitive restructuring trains the patient to repurpose the catastrophic thoughts into more realistic potential outcomes that does not necessarily leads to dire consequences(Curtiss et al., 2021).
In conclusion, CBT techniques should be utilized in complement of each other and is basically tailored towards an individualized plan of care for each patient.
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