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Maria and Andrea: Comparing Positive and Negative Outcome Cases in an Online, Clinician-Guided, Self-Help Intervention for Panic Disorder

Amalia M. Ciuca, Thomas Berger, Mircea Miclea

Abstract


Hundreds of clinical trials offer strong efficacy evidence that Internet-Based Cognitive-Behavioral Treatment (ICBT) interventions can contribute substantially to reducing the gap between mental health care needs and service use by providing better access to quality treatments. However, in order to use these interventions more efficiently, we need to find the best ways to tailor the interventions according to individual client characteristics, such as severity of symptoms, comorbidity problems, personality traits, life context, and position on the stage-of-change continuum. In line with this, this article documents how the individual process of psychological treatment unfolds during a specific IBCT program for Panic Disorder, called "PAXonline," with therapist guidance via Skype. The challenges and progress made by the two clients—a positive-outcome client named "Maria," and a negative-outcome client named "Andrea"—are presented using the particular mixed-methods model approach proposed by Fishman (2008; 2017), called the "Individual–Case-Comparison" (ICC) method. Contrasting Maria and Andrea’s case studies explores the role that individual client characteristics can play in determining outcome in ICBT treatment.   


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