Table 1 Inclusion and exclusion criteria at each stage of the study

Inclusion Criteria:

1. Male or female

2. 21+ years of age

3. Triage level 1 (not life-threatening condition), 2, or 3

4. English or Mandarin speaking

5. Able to provide informed consent and read study materials

6. Presenting complaint of chest pain, palpitations, dizziness, or breathing difficulties

7. Score ≥ 3 on the CDR screener

Exclusion Criteria:

1. Altered mental status (dementia, psychosis, substance intoxication/withdrawal)

2. Prisoner or police case

3. History of psychosis or schizophrenia or actively suicidal

4. Life-threatening condition requiring resuscitation

5. Not English- or Mandarin-speaking

6. Unwilling or unable to complete study procedures

7. Clear organic cause for panic symptoms as symptoms of potentially life threatening organic disease (e.g., acute coronary syndrome, STEMI, NSTEMI, angina pectoris), pneumothorax, aortic dissection, pulmonary embolism, tumour, effusion, rib fractures, pneumonia as determined by the ED physician

Inclusion Criteria:

1. Diagnosis of panic attack or panic disorder confirmed by the SCID interview

2. Willing to enter randomized trial

Exclusion Criteria:

1. Does not meet criteria for panic attack or panic disorder based on the SCID interview

2. Received CBT for panic symptoms in the last 12 months

3. Unwilling to enter randomized trial