title: Treatment engagement in the early phase of cognitive-behavior therapy for panic disorder: A grounded theory analysis of patient experience.
abstract: Exposure-based cognitive-behavior therapy (EBCBT) is the treatment of choice for panic disorder (PD). However, little is known about early treatment processes that facilitate retention in treatment and positive outcomes of PD treatment. We studied the development of early treatment process with semi-structured individual in-depth interviews with 12 patients with PD, conducted post session 3. Grounded theory was used to analyze the transcripts. The development of early treatment process was captured by four thematic categories: approaching the problem, easing in and opening up, building trust and bonding, and making sense of panic. The developmental scheme culminated to the core category: Jointly Engaging in PD Therapy versus Awaiting Relief, capturing early engagement or disengagement from PD therapy respectively. The emergent core category was cross-validated against distal treatment outcome. Emergent processes can be replicated and incorporated in early treatment procedures of EBCBT for PD. Clinical practice recommendations are discussed.
authors.affiliation: a Behaviour Therapy Unit (BTU) , Hellenic Center of Mental Health and Research , Athens , Greece.|b Adolescent Health Unit, Second Department of Pediatrics, P. & A. Kyriakou Children's Hospital , National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Eleni C
authors.initials: EC
authors.lastname: Tzavela
authors.affiliation: a Behaviour Therapy Unit (BTU) , Hellenic Center of Mental Health and Research , Athens , Greece.
authors.forename: Paschalia
authors.initials: P
authors.lastname: Mitskidou
authors.affiliation: c General Children's Hospital P. & A. Kyriakou , Athens , Greece.
authors.forename: Antigoni
authors.initials: A
authors.lastname: Mertika
authors.affiliation: d Department of Psychology , Panteion University of Social and Political Sciences , Athina , Greece.
authors.forename: Anastassios
authors.initials: A
authors.lastname: Stalikas
authors.affiliation: a Behaviour Therapy Unit (BTU) , Hellenic Center of Mental Health and Research , Athens , Greece.
authors.forename: Yiannis
authors.initials: Y
authors.lastname: Kasvikis
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D066296:Grounded Theory; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D016584:Panic Disorder / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D017064:Process Assessment, Health Care / Q000379:methods*; D013811:Psychotherapeutic Processes; D036301:Qualitative Research
keywords: cognitive-behavior therapy; early treatment; panic disorder; patient engagement; qualitative research