Effectiveness of Intensive Cognitive Behavioral Therapy in Treating Adolescent Panic Disorder and Agoraphobia
Condition: Panic Disorder; Agoraphobia
MeSH terms: Panic Disorder; Agoraphobia
Study type: Interventional
Phase: Phase 2

Summary: 
      This study will evaluate the effectiveness of intensive cognitive behavioral therapy in
      treating adolescents with panic disorder with agoraphobia.
    

Detailed description: 
      Panic disorder (PD) in adolescents is a prevalent and chronic anxiety disorder. People with
      PD experience unexpected attacks of fear, along with elevated heart rate, dizziness,
      faintness, weakness, and increased sweating. During these panic attacks, people may feel
      numbness in their hands, flushed or chilled, nauseous, or pain in the chest, and they may
      lose touch with reality. PD can lead to substantial social impairment for adolescents,
      including avoidance of school, independent activities, and peer involvement. When PD
      progresses so far that a person avoids public places where a panic attack might occur, the
      person is said to have a condition known as agoraphobia. Weekly sessions of cognitive
      behavioral therapy (CBT) appear to be effective in treating panic disorder with agoraphobia
      (PDA). However, many adolescents with PDA and their families report the need for a more
      immediate relief from the disorder. This study will evaluate the effectiveness of intensive
      CBT in treating adolescents with PDA.

      Participants in this single blind study will be randomly assigned to one of three conditions:
      intensive CBT treatment including family members, intensive CBT treatment without family
      members, or a waitlist control group. All participants in the intensive CBT treatment groups
      will undergo 8 days of intensive CBT, for a total of 6 sessions. On Days 1 through 3 of
      treatment, participants will attend daily, 2-hour CBT sessions. The CBT sessions will include
      psychoeducation about anxiety, tactics to restructure anxiety-provoking thoughts, and
      exposure to bodily sensations that trigger panic. On Days 4 and 5, participants will meet
      with a therapist to learn ways to approach previously feared situations. On Days 6 and 7,
      participants will continue working independently or with family members to solidify skills.
      On Day 8, participants will attend a final 2-hour session to consolidate skills, review the
      independent weekend activities, and discuss ways to apply skills to the home environment.
      Parents of participants in the parental involvement group will attend the last 30 minutes of
      sessions, complete homework assignments, learn ways to coach their children through episodes,
      and participate in selected exposures. After 6 weeks of waitlist, participants in the
      waitlist control group will receive active treatment following the same procedures as the
      initial active treatment. All participants will be assessed at Months 3, 6, and 12
      post-treatment.
    

Intervention name(s): Intensive panic control treatment without parent involvement; Intensive panic control treatment with parent involvement; Waitlist control
Intervention type(s): Behavioral; Behavioral; Other
Intervention description(s): Intensive panic control treatment without parent involvement is an 8-day, intensive form of cognitive behavioral therapy (CBT) with exposure, including 15-20 hours of direct therapist contact. The basic treatment components are psychoeducation about anxiety, restructuring anxiety-provoking thoughts, exposure to bodily sensations that trigger panic, and in vivo exposures.; Intensive panic control treatment with parent involvement involves the same form of intensive CBT, but with direct parent involvement. Parents will attend the last 30 minutes of didactic sessions, complete homework assignments, learn ways to coach their children, and participate in selected exposures.; Waitlist control participants will receive active treatment (treatment with or without family involvement) after 6 weeks of waitlist.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment