One-Week Intensive Program for Panic Disorder with Agoraphobia

Aside from the typical treatment we provide, consisting of one-hour sessions once a week, we also offer a number of condensed intensive programs. This treatment, which was featured on 48 Hours, is a highly specialized, very intensive form of therapy for people whose primary problem is Panic Disorder with moderate to severe agoraphobia. It is administered over a period of eight days. Patients typically arrive in Boston on a Sunday, begin treatment on Monday, and leave on the following Monday. While they are here, they devote full time to the treatment. Much of the time (on the order of 15-20 hours) they are working with a therapist, but that is heavily supplemented with reading and other assignments. The goal is to have patients working independently of the therapist by the 5th day. In addition, it is crucial that patients are willing to experience considerable anxiety, as well as panic attacks, during portions of the treatment, in order to overcome their disorder.

We have been doing this treatment in its current form since February 1999, when it was first featured on 20/20. The patients shown on 20/20 and 48 Hours were randomly chosen and are representative of the patients we have treated. The therapists are psychologists, advanced doctoral students in clinical psychology, or post-doctoral fellows, who have been highly trained in this treatment.

Is This Program Right for You?

This program is right for only a small percentage of people with anxiety problems. To benefit from it, your principal problem must be panic disorder and you must be avoiding multiple situations or activities because of concerns about panic attacks. If you are not avoiding things because of panic attacks, this treatment is not appropriate for you. There are also some medical and psychiatric conditions that would make this form of treatment inadvisable for you or would detract considerably from its effectiveness. Examples are substantial depression, psychotic symptoms, use of certain drugs or excessive alcohol, problems with comprehension, and medical problems that need stabilization or substantially limit your physical activity. We will do a diagnostic assessment to determine whether you are appropriate for the program from a psychiatric standpoint. You also need to have had a medical evaluation within the past year, or since the start of your panic symptoms if they began more recently than a year ago.

To take part in this program you must be able to travel to Boston and stay here for a period of one week. This often is very difficult for people with agoraphobia. And as mentioned earlier, you must be willing to experience considerable anxiety and panic symptoms during the course of treatment. This is essential to your recovery. If you are not willing to do that, this treatment will not work for you.

Ideally, we prefer that patients not be taking medication for panic disorder at the time of this treatment. Studies suggest that people who are taking medication during cognitive behavioral therapy have an increased risk of relapse later. However, if you are on a stable dose of medication (no change within the past month for benzodiazepines or 3 months for antidepressants) and are still significantly impaired by panic disorder or agoraphobia, we will accept you. In that case, we will ask you not to change your medication dose during treatment, with one exception. The exception is that as-needed (PRN) benzodiazepine use is not permitted once treatment begins.

Even if this program is suitable for you, you should be aware that there are other effective, less expensive treatments for panic disorder, including standard forms of cognitive behavioral therapy that are typically conducted on a weekly basis over a period of three or four months. Our program was designed for people who do not have access to other forms of treatment, have not responded to them, have time constraints, or prefer a very intensive form of therapy.

Cost

The cost of an assessment and treatment is $3,700 (a nonrefundable deposit of 20% of this fee must be paid a week prior to the start of the program).  The balance is payable at  the start of the first day of treatment. In addition, you will need to pay any costs necessary for the out-of-office work (for example, car rentals, transportation fares, other costs of travel away from the clinic, or admission fees) for both yourself and, if the therapist needs to come along, for the therapist. If you stay in a hotel while you are in Boston (which we recommend that you do), we can assist you with reservations and may be able to get you a slightly discounted rate. We do not provide accommodations. We regret that we do not accept insurance and cannot guarantee that insurance companies will reimburse you for the program. However, we will be glad to provide a statement that can be submitted to insurance companies.

Screening Procedure

Because of the significant cost and effort the intensive program entails, we want to be sure that the persons we accept are good candidates for this form of treatment. To help us evaluate that, we do a careful assessment by telephone and mail before we offer treatment. The assessments involve several steps, beginning with a telephone screen by one of our staff. These are standard questionnaires that we use routinely with patients we see in our Center, and they will give us a clearer picture of your anxiety problem.

After we receive your completed questionnaires, one of our staff (generally the person who would be your therapist) will call you to discuss the results and, if things are still positive, conduct or arrange for the final step in the screening process, a detailed diagnostic interview by phone. Following that interview, we can talk to you knowledgeably regarding treatment. We regret putting you through so many hoops, and we hope you will appreciate that it will be to your benefit in the end and may save you from wasting your time and additional money.

We urge you to consider carefully whether this is the kind of treatment you want. If you have any doubts, it probably would be better for you to start with a more standard form of therapy closer to where you live. But if you think this kind of program is right for you, you can get more information or start the screening process by calling us at (617) 353-9610, or by emailing either Bonnie Brown (our nurse administrator) or Todd Farchione, Ph.D. (program coordinator)