CBT also focuses on behavior change. CBT therapists teach their patients how to change the way in which they cope with fear-inducing events. Gradual exposure to the stimulus, such as a visit to the supermarket checkout line, is often a part of the treatment.
CBT differs from traditional psychotherapy in its focus on the present and the future, instead of the past. While the CBT therapist and the patient should have a good working relationship, the connection between them is less important than the learning of new thought patterns. The number of sessions is usually limited. CBT also emphasizes homework for the patient, which is a departure from typical psychotherapy practices.
Applying CBT to Panic Disorder
A panic attack is a physical response to a feeling of fear or distress. Our bodies are physiologically conditioned to increase adrenaline flow and pump blood to our muscles, in order to prepare to either fight or flee the source of fear.
People who have panic attacks have interpreted something as fear-inducing or dangerous, and their bodies have responded in kind. Their distorted thoughts cause them to fear something, and the sensation of anxiety increases their feeling of fear. CBT causes them to question their identification of a stimulus as dangerous. For example, someone whose panic attacks are set off by standing on the checkout line at the supermarket can learn to identify the fear-inducing stimulus (the thought of being trapped), then can learn to correct that thought (he or she can walk out at any time).
Psychiatric Social Workers and CBT
Given the strength of the research, and the prevalence of panic disorder, social workers who deal with a psychiatric population should learn to administer CBT. Every year, about one in twenty Americans is diagnosed with panic disorder. According to the NASW (2006), social workers provide more than 60% of mental health treatment in the U.S. It follows that they should be equipped to use the ‘best practice’ when treating their patients.
Although many social workers excel in administering generalist or psychodynamic techniques, they will typically find that methods such as offering validation and helping patients to connect their past with their present are of limited value to patients with panic disorder. CBT, the “gold standard,” is often the better path to take.
Gonzalez-Prendes, A., and Brisebois, K. Cognitive-Behavioral Therapy and Social Work Values:A Critical Analysis. (2012). Journal of Social Work Values and Ethics. Accessed on May 29, 2013.
Bystritsky, A., and Khalsa, S. Current Diagnosis and Treatment of Anxiety Disorders. (2013). Pharmacy and Therapeutics. Accessed on May 29, 2013.
Otte, Christian. Cognitive Behavioral Therapy in Anxiety Disorders: Current State of the Evidence. (2011). Dialogues in Clinical Neuroscience. Accessed on May 29, 2013.
Barlow, D., and Gorman, J., et.al. Cognitive-Behavioral Therapy, Imipramine, or Their Combination for Panic Disorder: A Randomized Controlled Trial. (2000). The Journal of the American Medical Association. Accessed on May 29, 2013.
American Psychological Association. Anxiety Disorders and Stress. Accessed May 30, 2013.
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