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Letters to the Editor |

Cognitive-Behavior Therapy by Any Other Name Still Smells as Sweet

Ross G. Menzies, PhD
Arch Gen Psychiatry. 1998;55(7):664-665. doi:10.1001/archpsyc.55.7.663.
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In their May 1994 article on the nonprescriptive treatment of panic disorder, Shear et al report findings that supposedly "raise questions about the specificity of cognitive-behavioral treatment."1(p395) In fact, they merely demonstrate that when cognitive-behavior therapy (CBT) is presented in the guise of reflective Rogerian counseling, it still works.

I note with surprise that in the first 3 sessions of the nondirective, nonprescriptive, reflective psychotherapy condition subjects were taught that (1) hyperventilation plays a role in triggering panic; (2) misconceptions about the meaning of panic attacks play a role in the disorder; (3) panic is not an indication of serious physical or mental illness; (4) anxiety is an inborn, potentially adaptive reaction that is not inherently dangerous; and (5) certain situations/activities may become triggers for panic attacks. Thus, it seems that the "nonprescriptive" condition included some coverage of each of the major components of typical CBT programs for panic, namely, the role of respiration rates, irrational cognitions, and desensitization to specific panic cues.


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