Cognitive Behavior Therapy for Panic Attacks, Essay Example

Introduction 

Cognitive behavior therapy is a practical approach used in counseling to help clients understand how emotions are connected to behaviors. The focus of this type of therapy is to have the client to increase positive behaviors and decrease negative ones.  Cognitive behavior therapy is a newly developed treatment strategy that is grounded in theory and best practices through clinical use. The technique is effective in treating various disorders. Clients set goals and make changes in their lives and behaviors to meet the goals they have set. With this therapy, clients are given techniques to use to lessen panic attack episodes. Therapists serve as mediators to empower clients to control their panic issues. The client learns the process of cognitive restructuring in order to correct beliefs and misinterpretation about having panic attacks. The clients learn about physical and other cognitive symptoms that may be evident prior to a panic episode. Clients often are required to keep journals or diaries to chart patterns of behaviors. This approach helps clients by assisting them in connection how their emotions and feelings can dictate their behaviors. This type of therapy has been successfully used by clients who were dealing with numerous problems including: depression, eating disorders, drug and alcohol addictions, sexual abuse, and mental health. It is believed this approach is more effective because traditional therapy focus on the causes of the problems (Higgins, Hurst, Wistow, 1999). In traditional therapy, clients discuss what has gone wrong over and over again, and therefore relive the wrong daily without coming up with behavior changes that can alter the outcome. With cognitive behavior therapy, the client develops ways to overcome that passive role. Cognitive behavior therapy has gained popularity because of its flexibility and the focus it places on the client’s strength instead of weaknesses. The therapy model focuses on three points: meet the client where they are, change the client’s outlook on the situation so the client is in control, and flexibility to meet the client’s needs. Supporters of cognitive behavior therapy believe that solutions lie in changing the interactions of the client with their perceived problem. This allows the client to solve his/her own problems by overcoming habit patterns. (Bowles, Mackintosh, Torn, 2001)The client must set concrete goals and aspire to meet them. Clients will be encouraged to see themselves as normal. Finally, the clients are taught that small changes lead to life changes. When properly implemented, cognitive behavior therapy focuses on positive behavioral changes which will reinforce coping strategies ensuring success for client living with panic attacks.

Panic Attacks

Millions of people are affected by panic attacks. Panic attacks are characterized by increased heart rate, shortness of breath, chest pain, trembling, choking sensation, sweating, nausea, dizziness, and hot flashes and chills. The DSM guidelines suggest that a person diagnosed with panic attacks must show symptoms of 4 or more characteristics. For example, “Recurrent panic attacks that are themselves a focus of concern help define panic disorder.  DSM criterion B symptoms capture these concerns in terms of worry about attacks or escape/avoidance behavior designed to manage the attacks. The onset of panic disorder (PD) is most often in adolescence and early adulthood. PD is more common in women; women are also more likely to develop more severe agoraphobia” (Pollack, 1998). Often, victims of panic attacks have underlying causes that have led to the disorder such as previous alcohol addiction, rape victims, death of family members, and break-up of families. Victims of mental illness find it difficult to complete daily tasks. Some suffer from severe depression, while other may only have mild symptoms. Regardless to the severity, any form of mental illness can reduce the quality of life the sufferer has. Fortunately, many forms of mental illness respond well to treatment and therapy. Medication can be taken by people suffering from various mental illnesses to help restore a balance in the brain. Once the balance has been restored one’s mood will be regulated. However, psychotherapy is the most effective to way obtain lasting benefits. Most people who suffer from mental illness convey that it stems from some past event. The past event is often so debilitating that it cause the victim to feel hopeless about life. Feeling hopeless about the future will cause the victim to enter into a vicious cycle of highs and lows. The person suffering from mental illness will have days when they feel they are well, and days when they feel hopeless again. Solution focused therapy is one type of therapy that is used to assist people suffering from mental illness. This approach offers the victim hope by teaching them to look ahead. Often people who suffer from certain mental illnesses are unable to let go of a past event which keeps them depressed. This type of therapy is different from traditional therapy because it does not spend a great deal of time focused on past events. In traditional therapy, victims are taught that in order to understand their future they must spend considerable time delving into past events.  Solution focused therapy is an effective method to use with clients who are suffering different types of mental illnesses. (Department of Health 2002)

CBT Basic Concepts

The cognitive behavior therapy approach is based upon eight assumptions about the clients that will be served. First, it is assumed that the clients have the needed resources and strength to resolve problems. The practitioner will gradually get the client to focus more attention on the strengths than the weakness. Second, change is constant. Practitioners teach clients to behave as if change is inevitable. Third, the practitioner’s job is to amplify change. They teach the clients to focus on what is working rather than what strategies are not working. Fourth, practitioners do not need to know a lot about the problem to help the clients resolve them. Practitioners have access to the bare minimum historical information about the clients. Fifth, small changes equate to large changes. Small changes in various aspects of the clients’ life will produce the changes clients want to achieve. Sixth, the clients define the goal. Practitioners teach that there is more than one solution to all problems. What may work for one client may not work for another, so the clients define what their goal is. Seventh, rapid change is possible. Eighth, focus on changes that are tangible. Focusing on things that can’t be changed will hinder progress on things that can be changed. These strategies help clients by teaching them how to respond to the situation and not become fearful of the situation. Many people who suffer from panic attacks have anxiety when they know that they may encounter a situation that usually causes anxiety. For example, a client who has a fear of large crowds may become afraid and go into a panic attack just by thinking of an upcoming trip to the mall.

Depression

People who suffer from anxiety and panic attacks often suffer from depression because of the issue. Depression is an unbearable feeling of misery.  People who are depressed experience persistent sadness. Being depressed interferes with all aspects of the person’s life-work, social, and family.  People who are depressed may have any of the following symptoms: difficulty sleeping, thoughts of suicide, anxiety and constant worry, restlessness, reduced sex drive, irritability, loss of interest in previous pleasurable activities, and lack of motivation. Although depression is a mental disorder, it can produce physical symptoms. People suffering from depression may have unexplained aches and pains, loss of appetite, gain or lose weigh in a short period of time, lack energy, slow movement, and slurred speech. Depression victims often develop social anxieties as well; they may avoid social situations, leave home, quit their job, or reduce social interaction with friends or colleagues. (Department of Health 2002)  When working with clients of depression, practitioners attempt to help clients focus on happier aspects of their lives rather than aspects of their lives that they are unhappy with.  Often they use what is called the Miracle Question, which gets the client to visualize life without the problem they are trying to fix. (Bowles, Mackintosh, Torn, 2001).

Anxiety

Panic attacks are reactions to anxiety. Anxiety is the way a person reacts to stressful situations. This is not harmful until it becomes excessive and cause victims to be unable to function in their daily lives.  There are many forms of anxiety disorder. Generalized anxiety disorder is the most common anxiety disorder. Victims of this disorder have excessive anxiety more days than not. They may feel fearful of situations or tense about encounters People suffering from this experience fast heart rate, palpitations, shaking, chest pains, and even headaches. These physical symptoms are due to the person’s brain sending signals throughout the body that the person may be in danger. It is difficult for people’s body suffering from this disorder to distinguish between the levels of danger they may be in.  This disorder can be triggered by a major stressful situation like a family crisis, death, or illness. CBT is one of the most effective treatments for this disorder. (Bowles, Mackintosh, Torn, 2001). It helps to reduce the symptoms of anxiety restoring the victims’ quality of life.   In this therapy the practitioner will help the client understand his/her thought patterns. They will identify any harmful thought that is making the client anxious. The client may be asked to keep a diary of thoughts that occur when the client is having an anxiety attack. This helps the client to understand what types of situations trigger the attack and what types of techniques can be used to minimize the attacks.

Benefits of CBT

One of the major benefits of CBT is that it sheds light on the emotions, feelings, and thoughts that cause problem that the client is facing. With this therapy, clients are able to address the issue they are facing without feeling threatened or stereotyped. They are the experts in dealing with their issue. Issues such as depression, anxiety, and stress can be reduced and interpersonal relationships can be restored. Another benefit of this type of therapy is setting clear goals. The client and practitioner both know what the clients’ goal or goals are. Consequently, at the end of the treatment, both the client and practitioner can evaluate if the goal has been met. They both can determine if further therapy is needed. Yet, another benefit of this type of therapy is that it can be brief and can be done in conjunction with other solution steps. This type of therapy often takes place in six sessions or less. Most of the time is focused on setting goals and coming up with strategies to meet those goals. The focus of the therapy is the clients’ goals and not his/her past. (Bowles, Macintosh, Torn, 2001)

Conclusions

Although cognitive behavior therapy is a fairly new technique used in the mental health field, many practitioners and clients are pleased with it. This type of therapy is effective with disorders that alter the client’s behavior because it teaches clients ways to cope with the disorder by altering behaviors and thought processes. Clients prefer this type of therapy because it attempts to avoid negative stereotype formation. Practitioners know very little about the clients. The clients are in control of the therapy. Anxiety, depression, and eating disorders are some disorders that have responded well to CBT because they all stem from the client’s thought process. Consequently, cognitive rehearsal is a very effective technique used in CBT. Clients identify potential problems or issues that may cause panic attacks and mentally work through these issues prior to the event. This technique helps them reduce anxiety and identify possible solutions to obstacles beforehand.

References

Bowles, N., Mackintosh, C. and Torn, A. (2001) Nurses communication skills: an evaluation of the impact of solution focused communication training. Journal of Advanced Nursing 36 (3) 347-354

Carbaugh, R. J., Sias, S. M. (2010). Comorbidity of bulimia nervosa and substance abuse: Etiologies, treatment issues, and treatment approaches. Journal of Mental Health Counseling, 32, 125-138.

Carolan, M., Bak, J., Hoppe-Rooney, T., & Burns-Jager, K. (2010). An integrated feminist approach to disordered eating intervention in a university campus outpatient setting. Journal of Feminist Family Therapy: An International Forum, 22(1), 43-56.

Department of Health (2002) Mental Health Policy Implementation Guide: Adult Acute Inpatient Care Provision. DoH, London.

Higgins, R., Hurst, K., Wistow, G., et al (1999) Nursing acute psychiatric patients: a quantitative and qualitative study. Journal of Advanced Nursing 29 52-63

Pollack, M. H. (1998).  Rate of improvement during cognitive-behavioral group treatment for panic disorder.  Behaviour Research and Therapy, 36, 665-673.