Clinical Handbook of Psychological Disorders: A Step-By-Step Treatment Manual

Clinical Handbook of Psychological Disorders: A Step-By-Step Treatment Manual

Clinical Handbook of Psychological Disorders: A Step-By-Step Treatment Manual

Clinical Handbook of Psychological Disorders: A Step-By-Step Treatment Manual


Updated and revised, this bestselling reference features new chapters on bipolar disorder, cocaine dependence, and interpersonal psychotherapy for depression, as well as broader coverage of alcohol use disorders and sexual dysfunction.


The treatment protocol described in this chapter represents one of
the success stories in the development of empirically supported psychological treatments.
Results from numerous studies indicate that this approach provides substantial advantages
over placebo medication or alternative psychosocial approaches containing “common”
factors, such as positive expectancies and helpful therapeutic alliances. In addition, this
treatment has been cited by the National Institute of Mental Health Consensus Confer
ence as having empirical support for panic disorder, and it forms an important part of
every clinical practice guideline (from either public health or other sources) describing
effective treatments for this disorder. Most recently, results from a large multicenter study
evaluating this treatment protocol, both individually and in combination with leading phar
macological approaches, suggest that this approach compares favorably with pharmaco
logical approaches and is more durable over the long term. But this treatment protocol
has not stood still. In this chapter we present the latest version of this protocol, represent
ing numerous changes and additions to the treatment since the second edition of this
book.—D. H. B.

Advances continue in terms of cognitivebehavioral conceptualizations and treatments for panic disorder and agoraphobia. The conceptualization of panic disorder as an acquired fear of certain bodily sensations, and agoraphobia as a behavioral response to the anticipation of such bodily sensations or their crescendo into a full-blown panic attack, continues to be supported by experimental, clinical, and longitudinal research. Furthermore, the efficacy of cognitive-behavioral treatments that target fear of bodily sensations and associated agoraphobic situations is well established. In addition to presenting an up-todate review of treatment outcome data, this chapter covers recent theoretical and empirical developments in reference to the role of comorbid diagnoses, the effect of treatment for panic on agoraphobia, ways to improve long-term outcome, and the effect of medication on cognitive-behavioral treatments. The chapter concludes with a detailed, sessionby-session outline of a cognitive-behavioral treatment protocol for panic disorder with agoraphobia (PDA) or panic disorder without agoraphobia (PD; note that we also continue to use “panic disorder” as a general term). This protocol has been developed in our clinics and is hereafter referred to as “panic control treatment” (PCT). The full protocol is detailed in available treatment manuals (Barlow & Craske, 2000; Craske, Barlow, & Meadows, 2000).


“Panic attacks” are discrete episodes of intense dread or fear, accompanied by physical . . .

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