Skip to main content

Table 3 Paxonline panic disorder treatment

From: Internet-based treatment for Romanian adults with panic disorder: protocol of a randomized controlled trial comparing a Skype-guided with an unguided self-help intervention (the PAXPD study)

Modules Short description
Introductory module. Anxiety, from normality to pathology Psychoeducation concerning fear, anxiety, fight or flight response, the brain circuits involved in the fear response, etiology of anxiety and treatment directions. Normalizes patients’ reactions and sets correct expectancies.
Module 1. Understand what’s happening with you Introductory information on panic attacks, panic symptoms and how panic disorder develops. Study cases and video illustrations. Patients begin to register PD related behaviors and thoughts using online worksheets.
Module 2. Understand what you have to do Introducing treatment strategies, the treatment plan and boosting confidence and motivation for change.
Module 3. Reduce hyperactivation through breathing retraining Information on the effects of hyperventilation, breathing regulation and abdominal breathing exercises.
Modules 4 and 5. Reduce hyperactivation through autogenic training Inducing relaxation by using autogenic training exercises. Videos and audio files are provided for practice.
Module 6. Reduce hyperactivation through physical exercises Psychological and biological benefits of physical exercises are presented; how to use them regularly.
Module 7. Optimizing attentional functioning Attention biases in anxiety and panic disorder. Retraining attention away from the body and panic-like thoughts.
Module 8. Changing maladaptive conscious cognitions The importance of catastrophic thoughts and attitudes. ICAR technique for cognitive restructuring:
Identify catastrophic cognitions
Challenge each dysfunctional cognition
Find the Alternative cognition
Repeat the procedure
Module 9. Changing maladaptive unconscious cognitions Cognitive restructuring techniques for unconscious beliefs. Identify personal values and live by them.
Module 10. Avoidance reduction through interoceptive exposure Explain the mechanism of avoidance and prepare for exposure exercises. Reduce fear of bodily sensations through interoceptive exposure.
Module 11. Avoidance reduction through exteroceptive exposure Reduce avoidance behaviors through gradual exposure to feared situations.
Module 13. Positive emotions development Increase positive emotions in daily life through cognitive and behavioral exercises drawn from positive psychology practices.
Module 14. Relapse prevention Resume the intervention strategies, set the correct expectancies and make a plan to continue improvement and deal with relapse situations.
Module 12. You learn how to solve problems (optional) Learn to organize problems according to importance and urgency. Implement problem-solving technique.
Module 15. Reducing depressive symptoms associated with panic – behavioral activation (optional) Depression symptoms co-morbid to panic disorder. Behavioral activation techniques.
Module 16. Reducing depressive symptoms associated with panic – cognitive restructuring (optional) ICAR technique for cognitive restructuring of dysfunctional cognitions that induce and maintain depression.