ACT for Panic Disorder: Psychoeducation

ACT interoceptive exposure

Key Points

  1. In panic disorder treatment, the therapist begins with psychoeducation about what panic attacks are, why they happen and persist, and the difference between triggered and untriggered attacks.
  2. Sarah’s panic attacks were maintained by the negative reinforcement of avoidance. Her mind created a relationship between danger and the situational factors of the original panic attack. She avoided environments with similar characteristics, and her perception of danger was thereby reinforced, so her mind activated yet more panic symptoms.
  3. Exposure therapy creates new relationships in the client’s mind by offering a safe environment in which to experience feared symptoms paired with new coping skills.
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Panic Attacks

As we have seen, Sarah likes to understand why things are happening to her. So we want to start with psychoeducation around what panic attacks are, why they happen and keep happening, and how something like panic disorder develops.

Explaining symptoms is important, as people have experiences they fear, or feel they’re unusual, or that something’s wrong. Sarah was afraid she was experiencing derealization. She didn’t know that was a panic attack symptom, and worried she was “losing her mind”.

You can even bring out DSM-5. Show the client, these are the listed symptoms of a panic attack, and this is one of the most common. It reassures the client that they’re in knowledgeable hands, they aren’t alone, and their experience is normal with panic attacks.

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