Elena Welsh – Stop Panic In Its Tracks: Evidence-Based Treatment Strategies for Managing and Eliminating Panic Attacks

Outline

Assessment: Accurately Diagnose Panic and Anxiety Disorders

• Panic disorder vs. panic attacks that are secondary to other anxiety disorders
• Psychosocial factors that may exacerbate panic symptoms
• Impact on client’s social and occupational functioning
• Is the client’s support system inadvertently reinforcing panic symptoms?

INTEGRATING ACT, CBT, & MINDFULNESS INTO YOUR THERAPEUTIC TOOLBOX

Psychoeducation: The Essential Foundation of Anxiety Treatment

• Teach clients about the physiology of fearand avoidance in a non-pathologizing manner
• When the body is behaving normally, just at the wrong time!
• Physical sensations that comprise a panic attack
• How short-term relief (avoidance, distraction, etc) isn’t enough to yield long-term wellness
• Teach clients ‘the why’ of exposure before going through it

Cognitive Behavior Therapy (CBT): Target Cognitive Distortions that are Common in Anxiety

• Catastrophizing, jumping to conclusions, tunnel vision, emotional reasoning, and overgeneralization
• Tools to help clients gain awareness of and reframe distorted thinking
• Disrupt the link between thoughts and unhelpful/avoidance/escape behaviors
• Help clients critically examine the beliefs they hold about panic and its aftermath

Exposure Techniques: Breaking the Anxiety and Panic Cycle

• The importance of client buy-in for exposure to be effective
• How to develop graduated exposure plan
• Subjective Units of Distress (SUDs) ratings to improve clinician-client communication
• In-vivo vs. imaginal exposure
• The importance of remaining in an exposure exercise until fear subsides
• Modify exposure for telehealth

Acceptance and Commitment Therapy (ACT): Teaching Clients to “Drop the Rope”

• Values clarification
• Use of metaphors
• Exercises to increase comfort with difficult emotions and sensations

Tools for Calming the Body in the Midst of Panic

• Breathing skills to interrupt worry thoughts and slow down physiological panic symptoms
• Relaxation techniques to reduce vulnerability to panic
• Grounding techniques to lower the intensity
• How a daily mindfulness practice can reduce panic

Recovery Maintenance Tools: Make Sure Therapy is Working and Help Clients Stay on Track

• Individualized methods of tracking success and challenges
• Help clients maintain consistent skills practice and reduce avoidance behaviors
• Maintain a panic attack progress tracking tool
• Connect treatment to client’s goals and values

Other Clinical Considerations

• Anxiety and panic during challenging times
• Increased anxiety rates during public health crisis
• Complicating factors of hypochondriasis and panic disorder
• Limitations of the research and potential risks