SBIR-STTR Award

This is a Phase I Small Business Innovation Research (SBIR; R43/44) grant application to NIMH to support the development of an innovative, online training program in Panic Control Treatment (PCT). The current application represents a cooperative partnership between the PI's small business concern, Behavioral Tech Research, Inc., a company with an impressive history of developing innovative training programs for psychosocial treatments, and the Center for Anxiety and Related Disorders at Boston University, where PCT was developed and evaluated in a randomized controlled trial (RCT). PCT is a cognitive-behavioral, evidence-based treatment for panic disorder. The proposed online training program will substantially aid in the vital training of community mental health clinicians and other community practitioners in the utilization of this evidence- based treatment with diverse populations. Specifically, the initial aims of this Phase I application are to: 1) Determine content for the prototype utilizing an advisory board of experts, with multidisciplinary training expertise (i.e., prisons, public sector community mental health agencies, private practice environments, and psychiatry) ; 2) Create the prototype using an iterative process of development and evaluation; and, 3) Conduct a feasibility pilot study using a randomized controlled design to evaluate knowledge gains in PCT, recall of PCT components, and self-efficacy in conducting the initial two sessions with patients diagnosed with panic disorder. In the event of a successful Phase I test of feasibility, we will substantially expand the multimedia program and its evaluation in Phase II. Although empirically-based treatments do exist for people diagnosed with panic disorder, only a relatively small percentage of this population will receive such treatments. Panic Control Treatment (PCT) is one efficacious approach for the treatment of panic. The lack of effective treatment availability is compounded by inherent difficulties in providing clinicians with training in treatments like PCT, beyond written text manuals or infrequent workshops. The intent of this project is to develop a uniquely comprehensive and interactive online training in PCT, in order to improve clinical outcomes for patients suffering from panic disorder.

Thesaurus Terms:
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Panic attacks (PA) impact about 23% of adults in community samples. Panic disorder with or without agoraphobia (PDA) tends to be a chronic condition with a lifetime prevalence of 4.7%. When untreated, panic disorder (PD) often leads to debilitating problems, with severe financial and interpersonal costs. Panic Control Treatment (PCT) is an efficacious treatment for PD. The overarching goal of this project is to facilitate the dissemination of PCT (aka MAP;Mastery of Your Anxiety and Panic) to clinicians who treat PD by creating the Online PCT Training for Clinicians (PCT OLT). In Phase I, we produced an innovative OLT prototype comprised of 143 screens using an iterative process of development with feedback from target end-users and PCT experts. A randomized controlled trial (RCT;N=31) was then conducted comparing the PCT OLT to a control OLT. PCT OLT subjects significantly outperformed controls on all outcome variables, including knowledge, recall, and self-efficacy. Results were maintained at the one week follow up. The proposed Phase II project extends this work by expanding the OLT and its evaluation in Phase II. Specifically, we will include all remaining content from the PCT manuals and add additional clinical scenarios and performance-based interactivities. We will test the program's efficacy in a RCT (N=180) using an additive research design of three training approaches: text (n=60), text + PCT OLT (PCT OLT;n=60), vs. text + PCT OLT + expert weekly consultation (Hybrid;n= 60). Outcome variables will again include PCT knowledge, as well as self-efficacy in treating PDA clients with PCT. We will expand the assessments to include a computer- generated clinical application test of competence and fidelity to PCT and course completion. Subjects will be assessed pre- and post-training, then again at 30-day and 60-day post-training follow-ups. , ,

Public Health Relevance:
Although empirically-based treatments do exist for people diagnosed with panic disorder (PD), only a relatively small percentage of this population will receive such treatments. Panic Control Treatment (aka Mastery of Anxiety and Panic;MAP) is an efficacious treatment for PD. The intent of this project is to develop a uniquely comprehensive and interactive online training in MAP, to aid in the dissemination of this evidence based treatment, in order to improve clinical outcomes for patients suffering from PD.

Thesaurus Terms:
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