A comparison of Guided Imaginal Coping and imaginal exposure in the treatment of panic disorder

The present study evaluated the efficacy of a new intervention, Guided Imaginal Coping (GIC), compared to imaginal exposure (IEX), and a waiting-list control (WLC) condition among 24 clinic outpatients meeting DSM-III-R criteria for panic disorder (PD) or PD with agoraphobia. GIC was the more consistently effective intervention, with individuals demonstrating significant improvement in frequency and severity of panic attacks (Pas) as well as significant reductions in physiological and subjective arousal to provocative imagery. Individuals in the IEX intervention demonstrated less consistent improvement on the dependent measures, while individuals in the WLC condition essentially remained unchanged. Both GIC and IEX were effective according to a composite measure of clinically significant improvement. However, only GIC was superior to the WLC condition when clinical improvement was defined as zero PAs at follow-up. These findings, while preliminary, suggest that GIC can be added to the armamentarium of effective approaches to treating PD.