Anxiety and vertigo. Have to stay home!

Cognitive and exposure therapies for panic disorder 1.Cognitive therapy. The goals and procedures for each of the four sessions of cognitive therapy were as follows. In session one, clients were taught a model of understanding panic attacks emphasizing the cyclical relationship between thoughts and body sen- sations which forms the basis of the cognitive model of panic disorder (see Clark, 1986). Therapists explained the rationale and procedures of cognitive therapy. Clients and therapists began to explore the clients’ specific panic-related thinking styles using recent panic attacks experienced by the client as examples. In session two, therapists reviewed the cognitive model and helped clients to identify and dispute irrational beliefs, unhelp- ful automatic thoughts, and catastrophic images associated with anxiety and panic. In session three, identification and disputation of irrational panic and anxiety-related thoughts continued. In addition, therapists helped clients to generate a list of coping self-statements to use in challenging situations or in response to early signs of panic. In session four, clients practiced using coping self-statements while discussing panic attacks they had experienced in the past, challenges they were likely to face in the coming month, or both. 2. Exposure therapy. The goals and procedures for each of the four sessions of exposure therapy were as follows. In session one, clients were taught a model of understanding panic attacks that explains the phenomenon as a learned (i.e., classically conditioned) fear of normal physical sensations. Following from this model, the therapists provided a rationale for exposure therapy. One or two trials of exposure to physical sensations were carried out. For all participants, the first exposure exercise was voluntary hyper- ventilation (Clark et al., 1985). Sessions two through four followed the same format. Recent panic attacks were discussed in terms of conditioned fear of normal body sen- sations; the rationale for exposure therapy was reviewed; two to three trials of exposure to panic cues were carried out. Therapists utilized a wide variety of exercises to help participants create physical sensations associated with panic: voluntary hyperventil- ation, running in place, standing and sitting repeatedly, jumping jacks, head shaking, obstructed breathing (e.g., tissue over mouth and nose), imagery instructions and others. Therapists were encouraged to be creative in helping participants to generate sensations similar to those they experience during a panic attack or which they avoid out of fear of having a panic attack. For example, one participant consumed taco chips with cheese dip to induce a choking sensation. Therapists always engaged in the expo- sure exercises with the client. Regardless of the procedure used, exposure trials followed the same format. Two minutes of exposure exercise were followed by 5 minutes in which participants sat, eyes closed, and concentrated on physical sensations. Therapists and participants then discussed the exposure exercise and ways to make the experience more like a panic attack. Participants were generally encouraged to practice exposure exercises between sessions but were not given specific homework assignments. Ref: Research Paper...

undergo proper treatment protocol

Therapeutic guidelines to adhere