Dynamic treatment of panic disorder: a review

Article Abstract:

A literature review was conducted to study cases of panic disorder that were treated with a method known as dynamic treatment. Panic disorder involves attacks of acute anxiety, during which the patient may experience physical symptoms such as sweating and shortness of breath. The authors identified 35 cases of panic disorder in the research literature that had been treated successfully with the dynamic method, an approach that utilizes psychotherapy without medication. However, detailed descriptions of the treatments were only available for 10 of these patients. The patients first sought help when in a state of crisis; they felt that their symptoms of panic were out of control. Initially, the therapist sought to break through the panic and convey a firm and confident attitude to the patient, thereby establishing some trust. Treatments were frequent, usually more than one per week. In some cases, the patient's family was contacted and educated about the disorder and its treatment; this was very useful. Family members were sometimes asked not to pressure the patient and to continue with their own lives. In the early phase of treatment, patients became better able to describe their feelings and symptoms, and for some patients the attacks began to decrease in severity. As treatment continued, symptoms improved while the inner conflicts and events that precipitated the attacks were explored. Central to the therapy was showing the patient that certain feelings were linked to the panic attacks and that these feelings could be recognized and managed safely. The authors conclude that such an approach may be useful in treating panic disorder, but its role in relation to other treatments, such as drug therapy, is not yet clear. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Panic disorders, Panic disorder, Panic attacks

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Early dropouts from psychotherapy

Article Abstract:

Psychotherapy has a high dropout rate, which poses both theoretical and practical problems and may be attributed to a variety of factors. One factor is a disparity between expectations of psychotherapy and the reality. A prospective study was conducted to examine factors that contribute to the dropout rate among psychotherapy patients at a Texas medical center. At this center, patients who want therapy must apply, call back for a screening interview, and attend the screening interview. Only then, if accepted, does psychotherapy begin. The present study focussed on the role of the screening interval in the eventual persistence of the patient. All four screeners in the present study were senior psychiatric staff. The patients interviewed by one screener were found to drop out significantly more often than those of the other screeners; a 57 percent dropout rate compared with a 32 percent rate for the other screeners. Psychological tests and questionnaires completed by patients revealed that the screener with the highest dropout rate was perceived by the patients as more passive and less potent than other screeners. Furthermore, the patients interviewed by this screener felt they gained less new understanding during the interview when their responses were compared with the other patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Physician and patient, Physician-patient relations, Psychotherapy patients, Dropouts

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