Behavioural Experiment: “What If I Can’t Catch My Breath?”

This CBT behavioural experiment helps young people test the fear that being unable to catch their breath during panic could cause them to suffocate, stop breathing or die. It explains why breathing changes during panic and reinforces that feeling breathless can be uncomfortable without being dangerous.

Young people are guided to safely bring on breathing-related sensations, observe what happens and compare the outcome with what they feared. This helps reduce fear of breathlessness and supports new learning through experience.

References and Further Reading

  • Birmaher, B., & Ollendick, T. H. (2004). Childhood-onset panic disorder. In T. H. Ollendick, & J. S. March (Eds.), Phobic and anxiety disorders in children and adolescents (pp. 306–333). NewYork:Oxford University Press
  • Craske, M. G., & Barlow, D. H. (2001). Panic disorder and agoraphobia. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (3rd ed., pp. 1–59). The Guilford Press.
  • Craske, M.G. and Barlow, D.H., 2022. Mastery of your anxiety and panic: Therapist guide. Oxford University Press.
  • Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication-Adolescent © 2020 The Authors. Child and Adolescent Mental Health published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.8 Holly J. Baker & Polly Waite Supplement (NCS-A). Journal of the American Academy of Child &AdolescentPsychiatry, 49, 980–989.
  • National Institute for Health and Care Excellence (NICE) (2014) Anxiety Disorders (Online) Available at: www.nice.org.uk/guidance/qs53.
  • Richards, J.C., Richardson, V. and Pier, C., 2002. The relative contributions of negative cognitions and self-efficacy to severity of panic attacks in panic disorder. Behaviour Change, 19(2), pp.102-111.
  • Vizard, T., Pearce, N., & Davis, J. (2018). Mental Health of Children and Young People in England, 2017. Leeds: Health and Social Care Information Centre.
  • Waite, P. Protocol for a randomised controlled feasibility study examining the efficacy of brief cognitive therapy for the treatment of panic disorder in adolescents (PANDA). Pilot Feasibility Stud 8, 49 (2022). https://doi.org/10.1186/s40814-022-01009-z.