The two main types of panic disorder therapy are cognitive behavioral therapy (CBT) and rational emotive behavior therapy (REBT). REBT is generally considered the first effective method created for the treatment of panic disorders. CBT evolved out of REBT, but applies one distinct part of REBT as the entire framework of the therapy. The main difference between the two is that REBT takes the approach that the patient needs to understand what led to the disorder, while CBT almost entirely focuses on learning new types of behavior.
REBT was developed in 1955 by psychologist Dr. Robert A. Ellis, who is often considered one of the most influential psychotherapists in medical history. He developed REBT out of his belief that personality disorders were not any type of clinical insanity and could be cured by behavior modification. Until that time, many patients who suffered panic disorders and personality disorders were treated by using psychoanalysis as panic disorder therapy. Psychoanalysis is a type of therapy that typically seeks to find the underlying neurosis that may be causing the behavior. Ellis believed that psychoanalysis did not go far enough, that not only did the patient need to understand his behavior, but also needed supervised “coaching” to overcome the behavior.
Most patients who undergo REBT are first encouraged to discover the cause or trigger of their panic. Once the cause has been determined, psychologists generally try to help them discover why this trigger leads to panic. The various stages of panic are evaluated to help the patient understand why mere discomfort often escalates into full-blown panic. In addition, REBT uses elements of CBT, such as gradual exposure to situations that may lead to panic, for the patient to find ways to change his behavior and deal with the situation.
When used as a panic disorder therapy, CBT is not as focused on deep-seated psychological problems as is REBT. CBT typically concentrates on accepting that the patient has certain fears, without focusing on why the fears are present. This therapy sometimes works faster than REBT, though some psychologists do not believe it goes far enough in attempting to cure the patient. In fact, CBT is not necessarily about curing the fear, just adapting a behavior pattern that allows the patient to cope with the panic. Generally, CBT involves limited exposure to situations that cause panic and gradually escalates the exposure until the patient can experience the situations without panic.
Sometimes patients may need medications while they are involved in panic disorder therapy. In some instances, medication may become a permanent part of their treatment. Drugs are usually considered a last resort and are usually only given when panic is so severe that it has become dangerously debilitating.