Efficacy of cognitive-behavioral therapy for comorbid panic disorder with agoraphobia and generalized anxiety disorder.

Three adults had both panic attacks and daily worry. They got CBT for panic first, then CBT for worry.

The team tracked symptoms across weeks using a multiple-baseline design. Each adult started treatment at a different time.

Two adults reached high end-state functioning after the panic module and kept gains through the worry module.

The third adult improved later, showing the order of modules can matter.

Weiner et al. (2013) also used exposure for anxiety, but targeted dissociation instead of panic. Both studies show exposure helps different anxiety symptoms.

Bilek et al. (2023) added self-distancing prompts to youth exposure. Joane et al. added a full second CBT module for adults. Both papers tweak CBT to reach more symptoms.

Carr et al. (1985) warned that cognitive anxiety scores bounce around. Joane’s team took repeated measures, echoing that advice to check scores before trusting change.

If a client has both panic and GAD, you can run panic CBT first and worry CBT second. Track each phase closely. Two-thirds of adults in this small study hit solid recovery, so it’s worth trying when single-diagnosis protocols fall short.