Mastery of Anxiety And Panic For Adolescents: Riding The Wave: Therapist Guide

The Mastery of Anxiety and Panic for Adolescents: Riding the Wave program provides step-by-step instructions and evidence-based strategies to help teens build resilience and overcome anxiety.

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Chapter 1 – Introductory Information for Therapists

Chapter 2 – Assessment

Chapter 3 – Involving Parents

Chapter 4 – Session 1: Introduction to Treatment and the Three Component Model

Chapter 5 – Session 2: Physiology of Panic and Breathing Awareness

Chapter 6 – Session 3: Cognitive Component of Anxiety: Probability Overestimation and Catastrophic Thinking

Chapter 7 – Session 4: Cognitive Restructuring (Thinking Like a Detective)

Chapter 8 – Session 5: Interoceptive Exposure (Not Letting How We Feel Scare Us)

Chapter 9 – Session 6: Introduction to Situational Exposure

Chapter 10 – Session 7: Safety Behaviors and Exposures

Chapter 11 – Sessions 8–10: Exposure Sessions

Chapter 12 – Session 11: Relapse Prevention and Therapy Termination

Chapter 13 – Adaptation

Appendices

References

Front Matter

Overview

Mastery of Anxiety and Panic for Adolescents: Riding the Wave is a comprehensive cognitive-behavioral program designed specifically for adolescents aged 12–17 with panic disorder (PD) or panic disorder with agoraphobia (PDA). Adapted from the adult-focused Panic Control Treatment (PCT), it integrates psychoeducation, cognitive restructuring, interoceptive exposure, and situational exposure to address the core features of panic, including avoidance behaviors and misinterpretations of bodily sensations. The program includes a Therapist Guide and Client Workbook, complemented by an optional parental component that equips caregivers with strategies to support their adolescents, fostering a collaborative treatment approach. Flexible and adaptable, it can be delivered in 11 weekly sessions or an intensive 8-day format, making it suitable for various clinical settings. Part of the highly regarded Treatments That Work™ series, this program provides clinicians with a structured, evidence-based framework for effectively addressing panic and related anxiety disorders in young people.

Why Use This Resource?

This program provides a step-by-step, structured approach for addressing anxiety and panic in adolescents. It provides:

  • A structured, step-by-step treatment plan based on CBT principles.
  • A parent component to support family involvement and treatment adherence.
  • Tools to systematically reduce avoidance behaviors and build resilience.
  • Strategies for therapists to help adolescents confront and manage panic symptoms effectively.

Key Benefits

Structured

Offers a clear, session-by-session outline for delivering effective therapy.

Educational

Helps clients understand the nature of their difficulties.

Effective

Supports therapists in implementing effective interventions for managing anxiety and panic.

Trusted

Part of the Treatments That Work™ series, developed by leading experts.

Who is this for?

Panic Disorder

Recurrent unexpected panic attacks and fear of future attacks.

Agoraphobia

Avoidance of situations due to fear of panic-related distress.

Integrating it into your practice

01

Assessment

Use structured diagnostic interviews and self-report measures to confirm a diagnosis.

02

Education

Introduce the three-component model of panic (thoughts, physiology, behavior).

03

Challenge

Guide adolescents in identifying and restructuring maladaptive thoughts.

04

Expose

Design and implement interoceptive and situational exposure exercises.

05

Engage

Involve parents in reinforcing treatment strategies at home.

06

Monitor

Use worksheets to track progress and adjust interventions accordingly.

07

Prevent Relapse

Teach long-term strategies for managing anxiety beyond therapy.

Theoretical Background & Therapist Guidance

The Mastery of Anxiety and Panic for Adolescents: Riding the Wave program is grounded in cognitive behavioral therapy (CBT) principles and represents a developmental adaptation of the well-established Panic Control Treatment (PCT) originally developed for adults (Craske & Barlow, 2006). The adolescent version, referred to as PCT-A, integrates core CBT elements such as psychoeducation, cognitive restructuring, interoceptive exposure, and situational exposure, while also addressing developmental considerations relevant to youth aged 12 to 17. The treatment targets panic disorder (PD), both with and without agoraphobia, and is designed to reduce the cognitive misinterpretations, conditioned fear responses, and avoidance behaviors that sustain panic symptoms (Pincus, Ehrenreich, & Mattis, 2008).

PCT-A is structured around an 11-session model, with the option of a more intensive 8-day version. Early sessions focus on educating adolescents about the nature of anxiety and panic, including the fight-or-flight response and the role of hyperventilation. Cognitive restructuring techniques are introduced to help challenge distorted beliefs about bodily sensations and catastrophic thinking (e.g., fear of fainting or dying during a panic attack). Interoceptive exposure tasks, such as breathing through a straw or spinning in a chair, are used to evoke and then neutralize feared physical sensations. These are complemented by situational exposure exercises that encourage adolescents to gradually confront avoided settings such as schools, shops, or public spaces. The overall goal is to decondition fear associations and improve functioning across multiple domains (Hoffman & Mattis, 2000; Ollendick, 1995).

Empirical support for PCT-A is strong. In a controlled outcome study, adolescents who completed the program demonstrated significantly greater reductions in panic severity, anxiety sensitivity, and depressive symptoms compared to a waitlist group, with improvements maintained at three-month follow-up. Notably, many participants also reported enhanced quality of life and reduced functional impairment. The program includes a parent component, offering caregivers psychoeducation and guidance in supporting their adolescents' treatment goals. This collaborative framework acknowledges the influence of family systems on treatment outcomes and supports the generalization of therapy gains into everyday life (Diler et al., 2004; Mattis et al., unpublished data).

What's inside

  • Therapist guidance for structuring sessions and delivering interventions.  
  • Worksheets and monitoring tools to track panic episodes and cognitive patterns.  
  • Parent handouts to reinforce skills at home.  
  • Adaptations for younger children and intensive treatment formats.  
  • A structured workbook for adolescents to engage with the material.
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FAQs

This guide is specifically designed for adolescents, incorporating developmentally appropriate language, strategies, and a parent component.
The guide includes techniques for managing resistance, using motivational interviewing and gradual exposure methods to increase participation.
Parents are involved in reinforcing treatment concepts, modeling coping strategies, and reducing accommodation of avoidance behaviors.

How This Resource Improves Clinical Outcomes

By using this structured, evidence-based program, therapists can:

  • Provide a systematic approach to reducing panic symptoms and avoidance.  
  • Help adolescents develop coping skills that generalize beyond therapy.  
  • Engage parents in a supportive role, enhancing treatment adherence.  
  • Use data-driven assessments to monitor progress and adapt interventions.  
  • Improve long-term relapse prevention through structured strategies. 

References And Further Reading

  • Barlow, D. H. (2004). Psychological treatments. American Psychologist, 59, 869–878.  
  • Craske, M. G., & Barlow, D. H. (2006). Mastery of your anxiety and panic (4th ed.). Oxford University Press.  
  • Silverman, W. K., & Albano, A. M. (1997). Anxiety disorders interview schedule for DSM-IV, child and parent versions. Oxford University Press.  
  • Shear, M. K., et al. (1997). The Panic Disorder Severity Scale: A reliable measure. Journal of Clinical Psychiatry, 58, 555–563.