Improving outcomes in panic disorder in NHS talking therapies
| ISRCTN | ISRCTN43471225 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN43471225 |
| Integrated Research Application System (IRAS) | 363155 |
| Sponsor | Oxford Health NHS Foundation Trust |
| Funder | NIHR Oxford Biomedical Research Centre |
- Submission date
- 12/02/2026
- Registration date
- 13/02/2026
- Last edited
- 13/02/2026
- Recruitment status
- Recruiting
- Overall study status
- Ongoing
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
Panic disorder is often treated in NHS talking therapies services by psychological well-being practitioners (PWPs) at Step Two, also known as 'low intensity'. There is a need to improve recovery rates for panic disorder nationally in NHS talking therapies services. A previous pre-registered trial the authors conducted (now published) found a more specific psychological treatment for panic disorder (known as Focused CBT) was more effective than the current treatment as usual for panic disorder in NHS Talking Therapies services. Therefore, this study is being conducted to build on the previous research to examine if these same effects can be observed on a larger scale.
The research also aims to examine if focused CBT can result in further improvements on panic and agoraphobic specific measures including fearful panic thoughts and agoraphobic avoidance.
Who can participate?
Individuals who are 18+ years of age, of any sex and where panic disorder with or without agoraphobia is the main problem.
What does the study involve?
People with panic disorder at the NHS talking therapies service are asked if they would like to take part in the study. If so, they will be randomly placed (determined by chance) into either the 'focused CBT' treatment or the current treatment provided for panic disorder at the NHS talking therapies services. Participants will then receive the treatment they have been randomly allocated to. The symptoms and severity of the participant's panic, depression, anxiety and the participant's daily functioning are measured before they start treatment, during each treatment session and at the end of treatment. Panic fearful thoughts and agoraphobic avoidance are measured before treatment begins, mid-way through treatment and at the end of treatment.
What are the possible benefits and risks of participating?
Taking part could help improve the current psychological treatment for panic disorder with or without agoraphobia. It could also help with wider implementation of this focused CBT if deemed more effective. In addition, it would also mean participants will obtain psychological treatment for panic disorder with or without agoraphobia which may help with their difficulties with panic.
The research team do not anticipate any risk associated with taking part.
Where is the study run from?
Oxford Health NHS Foundation Trust (UK)
When is the study starting and how long is it expected to run for?
February 2026 - December 2027
Who is funding the study?
Biomedical Research Centre NIHR - Oxford Health NHS Foundation Trust (UK)
Who is the main contact?
1. Dr Saarim Aslam, saarim.aslam@psy.ox.ac.uk
2. Professor Paul Salkovskis, paul.salkovskis@hmc.ox.ac.uk
Contact information
Public, Scientific, Principal investigator
University of Oxford, Department of Experimental Psychology
Oxford Health NHS Foundation Trust
Isis Education Centre
Warneford Hospital
Oxford
OX3 7JX
United Kingdom
 ORCID ID |
0000-0001-7488-904X |
|---|---|
| Phone | +44 (0)7919819678 |
| saarim.aslam@psy.ox.ac.uk |
Public, Scientific
The Oxford Institute of Clinical Psychology Training and Research
University of Oxford, Department of Experimental Psychology
Oxford Health NHS Foundation Trust
Isis Education Centre
Warneford Hospital
Oxford
OX3 7JX
United Kingdom
| ORCID ID |
0000-0002-2951-2283 |
|---|---|
| Phone | +44 (0)1865 226 369 |
| paul.salkovskis@hmc.ox.ac.uk |
Study information
| Primary study design | Interventional |
|---|---|
| Allocation | Randomized controlled trial |
| Masking | Open (masking not used) |
| Control | Active |
| Assignment | Parallel |
| Purpose | Treatment |
| Scientific title | Improving talking therapies treatment of panic disorder: a randomised parallel trial |
| Study objectives | 1. Can we replicate previous study findings with a new, larger sample? That is, a difference in the clinical outcome of panic severity between individuals with panic disorder who receive focused CBT compared to those who receive Step Two Treatment As Usual (TAU). 2. Is there a difference in the clinical outcomes of depression, anxiety and one’s daily functioning between individuals with panic disorder who receive focused CBT compared to those who receive Step Two Treatment As Usual (TAU) on a larger scale? 3. Does agoraphobic avoidance and panic cognitions improve in line with panic outcomes and do they predict outcomes in panic severity? |
| Ethics approval(s) |
Approved 16/12/2025, South West - Cornwall & Plymouth Research Ethics Committee (2 Redman Place, Stratford, London, E20 1JQ, United Kingdom; +44 2071048071; cornwallandplymouth.rec@hra.nhs.uk), ref: 25/SW/0156 |
| Health condition(s) or problem(s) studied | Panic disorder with or without agoraphobia |
| Intervention | 1. Focused CBT: This will involve six-eight sessions, delivered by Qualified Psychological Wellbeing Practitioners (PWPs). Participants randomly allocated to this treatment will receive workbook modules to complete which will introduce each session's topic. They will be required to complete the workbook modules before each session as these workbooks will be used by the PWPs with the participants during the treatment sessions. The workbook modules and treatment sessions will use cognitive behavioural therapy (CBT) techniques tailored to panic disorder to help participants with their panic symptoms. 2. Treatment as usual has two different treatments which are currently provided by the NHS Talking Therapies Services taking part. These are (i) Guided Self Help (GSH) and (ii) computerised CBT (cCBT). GSH involves a consultation with a PWP followed by six-eight treatment sessions whereby the participant will be guided through different skills and techniques to help with the panic symptoms and difficulties. They are also given workbooks to complete prior to the sessions. cCBT is delivered on an online platform which involves seven modules teaching participants skills to help with their panic symptoms and involves online reviews by a PWP. Random allocation: Participants will be randomly allocated to either focused CBT or treatment as usual. Randomisation is being stratified by site and using blocked randomisation. The tool used will be an online randomisation tool such as ‘Sealed Envelope’. If participants are randomly allocated to treatment as usual, they will follow normal NHS Talking Therapies service procedures for allocation to either cCBT or GSH which involves a discussion of these options with the participant and an agreement between the participant and clinician of which is the most suitable option for them. This is the normal procedure for TAU in these services. Administration: Focused CBT is administered face-to-face or online via MS Teams. Both cCBT and GSH are administered either face to face, online via MS Teams or by telephone. This is based on participant preference and clinical need. Duration: Focused CBT intervention is a total of 6-8 weeks which is dependent upon the individual's panic presentation. Treatment as usual which is both Guided Self Help and Computerised CBT is also for 6-8 weeks. There is no follow up for this study. |
| Intervention type | Behavioural |
| Primary outcome measure(s) |
|
| Key secondary outcome measure(s) |
|
| Completion date | 31/12/2027 |
Eligibility
| Participant type(s) | |
|---|---|
| Age group | Mixed |
| Lower age limit | 18 Years |
| Upper age limit | 110 Years |
| Sex | All |
| Target sample size at registration | 94 |
| Key inclusion criteria | 1. Age 18+ 2. English speaking and able to complete questionnaires and workbooks in English 3. Any gender 4. The presence of recurrent panic attacks whereby some are unexpected 5. Panic disorder with or without agoraphobia is the main problem as identified in the problem descriptor |
| Key exclusion criteria | 1. Panic is not the primary difficulty 2. Individual does not have capacity to consent 3.Those with long term physical health conditions 4. Those who are involved in another research project 5. Risk/safeguarding cannot be managed 6. Substance/alcohol use that would impact on therapy and individual unwilling to work to reduce this use 7. Inability to access materials, for example, technology barriers |
| Date of first enrolment | 20/02/2026 |
| Date of final enrolment | 31/08/2027 |
Locations
Countries of recruitment
- United Kingdom
- England
Study participating centre
Sandford Road
Littlemore
Oxford
OX4 4XN
England
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|
Editorial Notes
12/02/2026: Trial's existence confirmed by NHS HRA.
