Advancing CBT for panic disorder and agoraphobia by integrating a digital intervention into treatment: a pilot randomized controlled trial

Cognitive behavioral therapy (CBT) is the first-line treatment for panic disorder and agoraphobia. Supportive digital technologies can enhance the effectiveness of CBT. This pilot randomized controlled trial (RCT) investigates if patients with panic disorder and/or agoraphobia benefit from blended cognitive behavioral therapy (bCBT), combining standard CBT with an integrated digital application. Patients were randomized into two study groups: The bCBT group, receiving standard CBT plus a digital application (elona therapy) used between sessions (n = 34), and the control group, receiving standard CBT alone (n = 22). Anxiety, depression, quality of life, work and daily functioning, and mental health literacy were assessed at baseline (T0), at 6 weeks (T1), and at 12 weeks (T2). Improvements in anxiety symptoms were descriptively larger for the bCBT group at 6 weeks (d = -.28), though not significantly. The bCBT group showed significantly greater improvement in depression symptoms than the standard CBT group at 12 weeks (d = -.46 p = .028). Improvements in other secondary outcomes were descriptively larger for bCBT but not significant. bCBT shows promise in enhancing CBT for panic disorder and/or agoraphobia, warranting further research with larger RCTs.