Self-directed versus therapist-directed cognitive behavioral treatment for panic disorder

This study investigated two approaches to providing cognitive behavioral therapy for panic disorder: self-directed and therapist-directed. Sixteen individuals with panic disorder were randomly assigned to the treatment conditions. All participants were provided with a workbook describing cognitive-behavioral treatment (Mastery of Your Anxiety and Panic by Barlow & Craske). Therapist-directed participants worked through the material over 12 weekly therapy sessions. Therapists met with self-directed participants three times over 12 weeks to assign readings and answer questions. A fourth meeting was devoted to posttreatment assessment. Participants in both conditions improved with treatment and maintained their gains at 6-months follow-up. There were no differences between the treatment conditions on outcome measures. Forty percent and 28.6% of self-directed and therapist-directed participants, respectively, met conservative criteria for high end-state functioning at follow-up.