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Panic disorder and agoraphobia tend to be chronic conditions, often with an unremitting course, considerable social, occupational, and physical disability, and high rates of comorbidity. Formal cognitive behavioral therapy (CBT) begins with appropriate psychoeducation about the nature and the causes of panic and anxiety, and the aforementioned vicious cycle of a panic attack. In the cognitive restructuring component of CBT, detailed self-monitoring of emotions and associated cognitions is used to identify specific faulty beliefs, appraisals, and assumptions. The chapter describes science of exposure therapy, and differential diagnosis for panic disorder. It also discusses psychiatric and medical comorbidity and whether comorbidity could or should influence our standard care, the possible advantages of combined cognitive behavioral therapy (CBT) and antidepressant medication treatment, as well as the possible adaptations of CBT for ethnically and culturally diverse clients.
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