Modifying CBT to treat panic disorder in patients with schizophrenia

Although individuals with schizophrenia often have other psychiatric condit ions, such as panic disorder; less treatment attention is typically focused on this problem. Although established, efficacious cognitive behavioral tr eatments (CBT) exist, rarely have these interventions been used with indivi duals with schizophrenia. Our objective is to further improve the effective ness (clinical utility) of an empirically validated treatment for panic dis order Specific strategies are discussed regarding the modification of the t reatment environment, the role of other providers, the establishment of rap port and the therapist-patient relationship when utilizing CBT for panic di sorder with patients with schizophrenia. Furthermore, issues related to cul tural differences, trauma history, and ethics are explored. Additionally, t he treatment approach is outlined and the limitations of a standardized tre atment intervention are discussed. Finally, a case example of a client with schizophrenia and panic disorder treated with a modified version of an emp irically validated, cognitive behavioral protocol for panic disorder is off ered to illustrate the points.