Treatment engagement in the early phase of cognitive-behavior therapy for panic disorder: A grounded theory analysis of patient experience

Abstract

Exposure-based cognitive-behavior therapy (EBCBT) is the treatment of choice for panic disorder (PD). However, little is known about early treatment processes that facilitate retention in treatment and positive outcomes of PD treatment. We studied the development of early treatment process with semi-structured individual in-depth interviews with 12 patients with PD, conducted post session 3. Grounded theory was used to analyze the transcripts. The development of early treatment process was captured by four thematic categories: approaching the problem, easing in and opening up, building trust and bonding, and making sense of panic. The developmental scheme culminated to the core category: Jointly Engaging in PD Therapy versus Awaiting Relief, capturing early engagement or disengagement from PD therapy respectively. The emergent core category was cross-validated against distal treatment outcome. Emergent processes can be replicated and incorporated in early treatment procedures of EBCBT for PD. Clinical practice recommendations are discussed.

Cognitive changes in health locus of control attributions after behavioral analysis in patients with panic disorder and/or agoraphobia

“…A qualitative study that examined the experiences of patients with PD+/-Ag, suggested that understanding the individual factors that maintain the disorder during the first BT sessions, is a key component for patients' subsequent therapeutic involvement. 9 The successful manualized exposure-based BT of patients with PD+/-Ag in a single session, accompanied by personalized self-help manual, 10 has confirmed the usefulness of active participation in the treatment outcome. Moreover, their emotional and functional gains and reduced relapses in long-term evaluations, may be due to this experiential training and empirical feedback, which seems to significantly modify the attribution of mental health locus of control.…”

Social Robots to Support Child and Family Care: A Dutch Use Case

“…In the testing phase, these requirements and behaviors will be systematically tested in real-world scenarios in the Child and Family Center. In health care communication settings, it is especially important that the child feels comfortable enough to share all necessary information with the caregiver, in order to provide the appropriate and most effective care possible (e.g., [17]). When looking at child-robot communication in the health care field, it is therefore essential to create a context of trust and safety, facilitating a bond between child and robot.…”

“…These communication aspects contribute to the enrichment of the the child-robot interaction and personalization of the treatment (e.g., [3]). Consequentially, since the social robot will in this way be able to better understand the child, it might stimulate trust and bonding in the child-robot relationship, which is essential for a successful therapeutic treatment (e.g., [17]).…”

Child’s Bonding and Self-Disclosing with a Robot in Family Care

“…In such health care communication settings, it is important that the child feels comfortable enough to share all necessary information with the caregiver (e.g., [20]). More specifically, it is essential to create a context of trust and safety, facilitating a bond between child and robot.…”