Panic disorder can be successfully treated using cognitive behavioral therapy. To meet the growing need for accessibility and availability of therapy services, PAXonline specialists have created an online intervention programme for the treatment of panic disorder. It consists of 16 modules that can be completed individually or with the assistance of a psychotherapist and is based on scientifically tested and scientifically validated protocols and intervention methods. Moreover, the effectiveness of this programme has been demonstrated in a controlled clinical trial involving 111 people with a primary diagnosis of panic disorder. This was the first study to evaluate the effectiveness of the first online intervention programme for panic disorder in Romania.
Panic disorder can be successfully treated using cognitive behavioral therapy. To meet the growing need for accessibility and availability of therapy services, PAXonline specialists have created an online intervention programme for the treatment of panic disorder. The effectiveness of this programme was demonstrated in a controlled clinical trial involving 111 people with a primary diagnosis of panic disorder.
The PAXPD programme and the controlled clinical trial
The study compared the effectiveness of two different ways of going through the online treatment programme – individually or with the assistance of a psychotherapist – with a waiting list control group. The issues monitored and evaluated were the extent to which people who completed the treatment modules, with or without assistance, had fewer symptoms of panic and depression, and also whether their thinking was less catastrophic, whether their fear of physical sensations and body vigilance were reduced. Last but not least, the researchers measured the adherence to treatment and the extent to which participants completed the program and were satisfied with its effectiveness.
Treatment modules – Participants completed the 16 treatment modules included in the programme over 12 weeks. They are constructed to follow the principles of online learning – there are clear and well-defined objectives, the content is easy to follow and understand, the information is presented in multimedia format, the patient receives immediate feedback on the assessment questions, and has the opportunity to save module materials and other additional content in a personal portfolio accessible at any time. Each module can be completed in 20 to 50 minutes, depending on the complexity and difficulty of the exercises included.
Participants in this study were divided into three groups, two according to how the programme could be completed – independently or with assistance – and one that served as a control (waiting list).
- The autonomous group completed the 16 modules individually, following a recommended schedule – one or two modules per week. Patients in this group did not receive support from a therapist, but managed to complete the programme on their own.
- The assisted group benefited from the guidance of a licensed psychotherapist. This took the form of 15-45 minute Skype sessions, scheduled almost weekly after the patient had completed the content and exercises in the treatment module. In total, patients could benefit from 10 sessions with the assigned psychotherapist.
- The waiting group had the opportunity to start treatment free of charge in the desired way (with or without assistance) 12 weeks after enrolment, during which time they were placed on a waiting list.
The results showed that, compared to the waiting group, both groups who completed the 16 treatment modules had lower levels of panic symptoms at the end of the programme – 69% of those assisted by a psychotherapist and 27% of those who completed the programme independently no longer met the criteria for a panic disorder diagnosis. Moreover, even if diagnostic criteria were still met, the intensity of panic and depression symptoms were significantly reduced in those who received active treatment compared to those who were on the waiting list
Not only were anxiety and depression symptoms reduced as a result of treatment, but also the extent to which people tended to think in catastrophic terms, the extent to which they paid excessive attention to bodily sensations, and the fear of these sensations, all important mechanisms involved in the onset and maintenance of panic disorder.
Overall, the degree of deterioration in the quality of life of people who underwent online treatment was significantly reduced compared to the waiting group.
All of these benefits were maintained or even increased 12 months after treatment completion.
Across the whole sample the level of satisfaction with the programme was very high, with 95% of respondents saying they would recommend the programme to others with similar problems.
95% of respondents to the follow-up interview would recommend the programme to another person.
In conclusion, the panic disorder treatment programme within the PAXonline platform (PAXPD) has proven to be effective in reducing symptoms of panic, depression as well as those factors that trigger and maintain panic disorder. People report a better quality of life and are satisfied with the programme, which supports its ability to reduce the costs of panic disorder, but also to bring benefits to people who complete it.
1. Ciuca, A., Berger, T., Crișan, L. G., & Miclea, M. (2018). Internet-based treatment for panic disorder: A three-arm randomized controlled trial comparing guided (via real-time video sessions) with unguided self-help treatment and a waitlist control. PAXPD study results. Journal of Anxiety Disorders, 56, doi: 10.1016/j.janxdis.2018.03.009
2. Ciuca, A. M., Berger, T., & Miclea, M. (2017). Maria and Andrea: Comparing Positive and Negative Outcome Cases in an Online, Clinician-Guided, Self-Help Intervention for Panic Disorder. Pragmatic Case Studies in Psychotherapy, 13(3), 173-216, doi: 10.14713/pcsp.v13i3.2011
3. Ciuca, A., Berger, T., Crișan, L. G., & Miclea, M. (2016). Internet-based treatment for Romanian adults with panic disorder: Protocol of a randomized controlled trial comparing a Skype-guided with an unguided self-help intervention (the PAXPD study). BMC Psychiatry, 16(1), doi: 10.1186/s12888-016-0709-9