Relapse Prevention Manual for Panic

The Relapse Prevention Manual for Panic was developed by Dr. Joseph Wright to fill an important gap in the long-term treatment and prevention of panic disorders. Based on the finding that panic disorder follows a chronic course with frequent relapses, the Relapse Prevention Manual for Panic was designed as a program for reducing vulnerability to relapse. It is designed to be self-administered or to be used in conjunction with follow-up supportive therapy or self-help groups.

Based on a careful analysis by Dr. Wright and Dr. George A. Clum of factors that contribute to relapse for individuals with anxiety disorders, the Relapse Prevention Manual for Panic targets each of these factors. Included in the manual are sub-programs for:

1. changing vulnerability to lapses after formal treatment is over
2. maintaining an attitude of "I am recovering" rather than an attitude of "I am recovered"
3. continuing an active program of self-exposure to feared situations in a context of practicing coping strategies
4. identifying stressors and knowing their relationship to relapse
5. Developing an active support system of people who understand panic disorder and agoraphobia.

This manual contains numerous case studies that illustrate the problems likely encountered after treatment as well as case studies of approaches likely to be successful. The manual is intended to function as a workbook on preventing relapse. As such, numerous self-administered assignments are provided that augment assignments from the treatment manuals.

Programs that target relapse prevention for anxiety are just beginning to be developed and evaluated. Self-administered relapse prevention programs have, with the exception of our evaluation of this manual, not yet been subjected to scientific scrutiny. The one exception to this is a study recently completed on the effectiveness of the Relapse Prevention Manual for Panic, which has been accepted for publication in The Journal of Anxiety Disorders. In this study, panic sufferers who completed our self-help program were assigned to either the Relapse Manual group or no further treatment. Individuals who received the manual were contacted briefly by phone once monthly to determine whether they were using the manual and to answer any questions they might have. Individuals in this group showed continued improvement compared to individuals who agreed to postpone receiving the manual for six months. The results of this study are very promising. They indicate that post-treatment improvement for panic sufferers can be enhanced using our Relapse Prevention Manual for Panic.

Table of Contents

Chapter 1: An Introduction to Your Relapse Prevention Program

Chapter 2: Beginning Your Relapse Prevention Program and a Review of Your Treatment Gains

Chapter 3: Guarding Against Unrealistic Expectations or How To Avoid Viewing Your Recovery in All-Or-Nothing Terms

Chapter 4: Enlisting Social Support for Your Relapse Prevention Program

Chapter 5: A Therapeutic Self-Exposure and Coping Skills Training Program

Chapter 6: Stress Management Techniques for Reducing Panic Attacks

Chapter 7: How to Respond to a Setback