This report is a post-hoc, exploratory examination of the relationships among patient motivation, therapist protocol adherence, and panic disorder outcome in patients treated with cognitive behavioral therapy within the context of a randomized clinical trial for the treatment of panic disorder (Barlow, Gorman, Shear, & Woods, 2000). Results suggested that motivation and adherence interacted to predict change in panic severity. Among patients rated as less motivated, greater therapist protocol adherence was associated with poorer outcome. Among patients rated as more motivated, adherence was not significantly associated with outcome. Further process research is needed to confirm these preliminary results and to understand the interactions of patient and therapist factors and how they are related to outcome in standardized protocols such as cognitive behavioral therapy for panic disorder.
Bibliographical noteFunding Information:
This work was supported by NIMH Grant No. MH45964 (Shear; Pittsburgh); MH45965 (Barlow; Boston); MH45966 (Woods; Yale); MH45963 and MH00416 (Senior Scientist Award) (Gorman; Columbia/Mt. Sinai). Dr. Shear is now at Columbia University School of Social Work.