The American Psychiatric Association Practice Guideline for the Treatment of Patients With Panic Disorder: Recommendations and Controversies

Fredric N. Busch, MD and Barbara L. Milrod, MD

In This Article

CBT Limitations

The guideline notes that there is a risk of dependence on the therapist in CBT and psychodynamic psychotherapy. Such dependency is a risk in any psychiatric treatment, and there are no systematic data that indicate that any have been delineated for a particular treatment modality. CBT may not address other psychological problems, since it emphasizes panic symptom relief, and such relief may be relatively less important if other disorders or environmental stresses are present. Although data from several studies indicate that more patients with panic disorder are willing to accept a non-medication approach, approximately 10% to 30% of patients are unable or unwilling to complete the requirements of CBT treatment, including daily exercises, continuous monitoring, and confrontation of feared situations.[22,23,24]


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