For Panic Disorder, Which Components of Cognitive-Behavioral Therapy Are Best?

Both pharmacotherapy (selective serotonin reuptake inhibitors) and psychotherapy are considered first-line treatments for panic disorder. Cognitive-behavioral therapy (CBT) is the most efficacious of the psychotherapies, according to a Cochrane review. However, CBT is complex and can involve many strategies, including psychological support, psychoeducation, breathing retraining, muscle relaxation, cognitive restructuring, interoceptive exposure to bodily sensations that accompany panic, in vivo exposure, virtual reality exposure, third-wave components (e.g., mindfulness), face-to-face interventions, and self-help. Identifying which components work best could simplify CBT, thereby streamlining training, decreasing costs, and improving access…