Introduction

Content

The workshop will cover diagnosis and differential diagnosis, cognitive theory, panic treatments, fine-tuning formulations, and working with complexity, including comorbidity.
The diagnostic section will consider panic attack versus panic disorder criteria, including time to peak, symptom count, and cognitive symptoms. Differential diagnosis will consider the various disorder that panic attacks can occur in, and how these differ from panic disorder. 
NICE Guidelines for Panic Disorder treatment will be reviewed.
Clark’s cognitive model of panic will then be discussed, with special reference to typical catastrophic cognitions often evident in panic disorder. Maintenance factors including safety-seeking behaviours, selective attention to bodily cues, imagery, and emotional reasoning will be considered. 
The process of fine-tuning panic formulations will be outlined, including identifying specific episodes, sequencing events, summarising, and collaboratively drawing out the vicious circle of panic. 
Case examples include clients with comorbid PTSD, osteogenesis imperfecta and social phobia, and OCD, will be used to illustrate how this fundamental formulation can be modified to account for complexity whilst retaining fidelity to the model. 
Behavioural experiments as a core strategy for helping clients to test their predictions and beliefs and the impact of safety behaviours in real life will be considered, along with tips on how to maximise the effectiveness of these. 
Strategies will be presented for preventing relapse include checking residual beliefs, anticipating future negative events, and summarising lessons learned. 
The presentation will discuss factors that can make panic disorder difficult to treat, and how therapeutic approaches can be adjusted accordingly.  Amongst others, this will include moving away from euphemisms, modelling physical experiments, and using imagery to decatastrophise frozen moments. 
The presentation will close with opportunities for feedback, reflection on learning, and identifying areas for further practice and enquiry. Attendees will receive copies of all supplementary materials to support learning.

Learning Objectives

• To be able to diagnose and differentially diagnose panic disorder, panic attacks, and comorbid conditions with confidence
• To be clear in sequencing succinct and accurate panic formulations
• To be able to design and execute appropriate behavioural experiments
• To be able to appropriately adjust to complexity and comorbidity when required, without drifting