Mastery Of Your Anxiety And Panic (Fifth Edition): Therapist Guide

This therapist guide provides a structured cognitive behavioral treatment (CBT) program for panic disorder and agoraphobia. It incorporates the latest research on inhibitory learning and exposure-based interventions, offering clinicians a step-by-step framework for delivering effective, evidence-based care.

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Chapter 1: Introductory Information for Therapists

Chapter 2: The Nature of Panic Disorder and Agoraphobia

Chapter 3: Outline of Treatment Procedures and Basic Principles Underlying Treatment

Chapter 4: Introduction to the Program

Chapter 5: Learning to Record Panic and Anxiety

Chapter 6: Negative Cycles of Panic and Agoraphobia

Chapter 7: Panic Attacks Are Not Harmful

Chapter 8: Establishing a Hierarchy of Agoraphobia Situations

Chapter 9: Breathing Skills

Chapter 10: Thinking Skills

Chapter 11: Facing Physical Symptoms

Chapter 12: Facing Agoraphobia Situations

Chapter 13: Involving Others

Chapter 14: Medications

Chapter 15: Accomplishments, Maintenance, and Relapse Prevention

Chapter 16: Therapist Guide for Brief Six-Session Version for Primary Care and Related Settings

Appendix

References

Front Matter

Overview

Panic disorder and agoraphobia can significantly impact people's ability to function. This therapist guide is part of the mastery of your anxiety and panic (MAP) program, which provides a structured approach to treatment. Now in its fifth edition, the program integrates the latest advances in exposure therapy, cognitive restructuring, and inhibitory learning principles.

This guide outlines a session-by-session treatment plan, providing detailed instructions for implementing exposure and response prevention (ERP), interoceptive exposure, and cognitive restructuring techniques. It also addresses therapist challenges, client resistance, and variations in treatment pacing.

Why Use This Resource?

This guide is an essential resource for clinicians working with individuals experiencing panic disorder and agoraphobia. It provides:

Evidence-based strategies – incorporates the latest research on inhibitory learning and exposure therapy.
Structured approach – offers a session-by-session treatment plan with detailed interventions.
Adaptability – allows for individualized pacing to match client progress.
Therapist guidance – includes case examples, troubleshooting techniques, and recommendations for managing treatment challenges.

Key Benefits

Structure

Provides a step-by-step framework for effective CBT interventions.

Flexibility

Allows therapists to tailor treatment to individual client needs.

Effectiveness

Incorporates strategies backed by decades of research.

Integration

Includes approaches for addressing comorbid conditions and medication considerations.

Who is this for?

Panic Disorder

Characterized by recurrent unexpected panic attacks and persistent worry about future attacks.

Panic Attacks

Acute episodes of intense anxiety marked by a rapid onset.

Agoraphobia

Marked by intense fear of situations where escape may be difficult.

Integrating it into your practice

Educate

Introduce clients to the CBT model for panic disorder and agoraphobia.

Assess

Use structured interviews and self-report measures to evaluate symptom severity.

Track

Implement symptom monitoring to observe patterns and progress.

Expose

Guide clients through interoceptive and situational exposure exercises.

Reframe

Teach cognitive restructuring to challenge catastrophic interpretations of symptoms.

Review

Evaluate client progress and adjust treatment plans as needed.

Theoretical Background & Therapist Guidance

The treatment approach outlined in this guide is rooted in cognitive behavioral therapy (CBT) principles and has been rigorously tested in multiple clinical trials. It integrates inhibitory learning models, emphasizing the role of exposure in promoting new learning rather than mere habituation.

The guide details how exposure helps clients tolerate discomfort while disconfirming catastrophic beliefs about bodily sensations and feared situations. By systematically confronting their fears, clients learn that their anxiety does not lead to the feared consequences, reducing avoidance behaviors over time.

A related component is interoceptive exposure, which involves deliberately inducing feared physical sensations (e.g., dizziness, breathlessness) to help clients habituate to these experiences. This is particularly beneficial for individuals with panic disorder who misinterpret bodily sensations as dangerous.

Cognitive restructuring techniques are also emphasized, helping clients reframe anxious thoughts and challenge misinterpretations of physical sensations. The therapist guide provides troubleshooting strategies for common challenges, such as client resistance, slow treatment progress, and comorbid conditions.

What's inside

Step-by-step session outlines for conducting CBT for panic disorder and agoraphobia.
Detailed exposure therapy guidance, including interoceptive and situational exposure.
Cognitive restructuring exercises for challenging anxious thinking.
Worksheets and assessment tools for tracking progress.
Therapist troubleshooting tips for managing treatment resistance.

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FAQs

The fifth edition integrates new research on inhibitory learning, enhancing the effectiveness of exposure therapy by focusing on tolerance rather than fear reduction.

No, this guide is designed for clinicians to use in therapy sessions. A separate workbook for clients is available to complement this treatment.

The program is structured around a 12-session format, but it allows for flexibility depending on client progress and severity of symptoms.

The guide includes recommendations for working with clients who are on SSRIs or benzodiazepines and how to integrate CBT with medication management.

How This Resource Improves Clinical Outcomes

Encourages long-term anxiety reduction through exposure-based learning.
Helps clients develop resilience to panic symptoms.
Reduces avoidance behaviors that maintain anxiety.
Provides a structured framework to maximize therapy effectiveness.
Equips therapists with strategies to tailor treatment to individual needs.

Clinicians Who Use This Resource Also Use

Mastery Of Your Anxiety And Panic (Fifth Edition): Workbook

References And Further Reading

Barlow, D. H., & Craske, M. G. (2022). Mastery of Your Anxiety and Panic: Therapist Guide (5th ed.). Oxford University Press.

Craske, M. G., Wolitzky-Taylor, K. B., & Barlow, D. H. (2021). Inhibitory learning and exposure therapy: Enhancing treatment outcomes for anxiety disorders. Clinical Psychology Review, 87, 102037.

Foa, E. B., & Kozac, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20-35.

Otto, M. W., & Pollack, M. H. (2009). Stopping Anxiety Medication: Therapist Guide. Oxford University Press.

NICE (2019). Generalized anxiety disorder and panic disorder in adults: Management. National Institute for Health and Care Excellence Clinical Guideline.

Unified Protocol For Transdiagnostic Treatment Of Emotional Disorders In Adolescents