Online Exposure and Response Prevention (ERP) therapy for panic disorder helps you become less afraid of panic attacks by gradually approaching feared sensations and situations while reducing the behaviors you use to prevent, escape, or control panic. Through secure video sessions, you work with a therapist to practice responding differently to panic in your everyday life.
And one of the benefits of doing ERP online? You can work on the fears and avoidance patterns that are actually showing up in your day-to-day life.
If you've spent years trying breathing exercises, coping skills, reassurance, and everything else you can think of to stop panic attacks, online ERP therapy offers a different approach.
Instead of focusing on how to stop panic, we focus on helping you stop fearing it.
What Is ERP Therapy for Panic Disorder?
Exposure and Response Prevention (ERP) is an exposure-based treatment approach that helps you gradually face what you're afraid of while reducing the behaviors you rely on to feel safe.
For someone with panic disorder, that often means learning to approach the physical sensations of panic and the situations where you're afraid another panic attack might happen.
Maybe you're afraid of your heart racing because you worry something is medically wrong.
Maybe you avoid driving on highways because you're afraid you'll panic and lose control.
Or maybe you constantly monitor how you're feeling because you want to catch a panic attack before it starts.
ERP helps you change how you respond to those fears.
The goal of ERP for panic disorder isn't to guarantee you'll never have another panic attack. It's to help you stop letting the possibility of panic control your life.
How Does ERP Therapy Work When Sessions Are Online?
Online ERP therapy takes place through secure video sessions, but treatment involves much more than talking about your anxiety.
We identify the sensations, situations, and behaviors that are keeping you afraid of panic. Then we develop exposure exercises to help you gradually approach those fears.
Some exercises can happen during our virtual sessions. Others take place between appointments in your everyday environment.
For example, if you're afraid of going into stores alone, we might develop a plan for gradually practicing that activity while reducing behaviors like constantly checking for exits or leaving as soon as anxiety appears.
If you're afraid of certain physical sensations, we may practice intentionally experiencing those sensations through exercises called interoceptive exposures, when medically appropriate.
Online ERP therapy allows us to work on panic where it's actually affecting your life, not just talk about it from a therapy office.
What Happens During an Online ERP Therapy Session?
ERP is a collaborative and active form of treatment.
While every person's treatment plan looks different, online ERP therapy generally involves several components.
1. Identifying What You're Afraid Will Happen During Panic
We start by understanding what makes panic so frightening for you.
Are you afraid you'll pass out, lose control, have a medical emergency, or go crazy?
Are you afraid of being somewhere you can't easily escape?
Understanding what you're afraid will happen helps us identify which sensations and situations to work on during treatment.
2. Identifying Your Avoidance and Safety Behaviors
Next, we look at what you're doing to prevent panic or feel safer when it happens.
These behaviors might include:
Avoiding highways, stores, restaurants, or traveling far from home.
Constantly checking your heart rate or monitoring physical sensations.
Only going places with someone you trust.
Staying close to exits or planning escape routes.
Reassuring yourself that you're okay.
Distracting yourself whenever panic sensations appear.
While these behaviors may provide temporary relief, they can also reinforce the belief that panic is something you must prevent or escape.
3. Practicing Exposures to Feared Sensations and Situations
Once we understand your fears and avoidance patterns, we begin practicing exposures.
For panic disorder, this may include interoceptive exposure, which involves intentionally bringing on certain physical sensations you've learned to fear.
For example, if you're afraid of an increased heart rate, we may practice experiencing that sensation without immediately trying to make it go away.
If you're avoiding certain places, we develop gradual exercises to help you return to those activities.
Exposures are individualized, collaborative, and planned with appropriate attention to medical and physical safety.
4. Practicing Response Prevention
This is an important part of ERP that often gets overlooked.
Exposure isn't just about putting yourself in an uncomfortable situation.
It's also about changing how you respond when anxiety shows up.
For example, you might go into a grocery store but spend the entire time monitoring your body, reassuring yourself, or staying close to the exit.
In ERP, we work on gradually reducing those behaviors rather than continuing to rely on them to get through the experience.
The goal isn't to prove you can tolerate panic as long as you have the right coping skills. It's to learn that you don't have to keep fighting, controlling, or escaping panic to live your life.
Can You Do Exposure Exercises at Home During Online Therapy?
Yes. Many ERP exercises can be practiced at home or in your everyday environment.
This can be especially helpful if your fear of panic has started limiting where you go or what you do.
For example, someone with agoraphobia might begin by practicing leaving home independently, walking farther from their house, or visiting a nearby store.
Someone who fears physical sensations might practice medically appropriate interoceptive exposures during a virtual session.
Other exercises may be planned between sessions, such as gradually returning to driving or traveling.
Activities like driving are practiced with appropriate safety precautions, rather than through distracting live video calls.
You don't have to wait until you're comfortable leaving home to begin working on your fear of leaving home.
Is Online ERP Therapy Effective for Panic Disorder?
Research supports therapist-guided online cognitive behavioral therapy, including exposure-based approaches, as an effective treatment option for panic disorder.
Online ERP uses many of the same treatment principles as in-person exposure therapy, including approaching feared sensations, reducing avoidance, and changing responses to anxiety.
One advantage of virtual treatment is the opportunity to apply what you're learning in the places where panic affects your everyday life.
However, online therapy isn't the best fit for every person. Your therapist should assess your individual needs and determine whether virtual treatment is appropriate.
How Long Does Online ERP Therapy Take for Panic Disorder?
The length of ERP treatment depends on your symptoms, goals, avoidance patterns, and how consistently you're able to practice between sessions.
Some people begin noticing changes in how they respond to panic before their panic attacks become less frequent.
For example, you might still experience anxiety while driving but stop immediately turning around when you notice your heart racing.
Or you might start going places independently, even though you're not completely comfortable yet.
Progress in panic disorder treatment isn't just about having fewer panic attacks. It's about being able to do more of what matters to you without letting the fear of panic make your decisions.
Frequently Asked Questions About Online ERP Therapy
Can ERP therapy help if I've had panic disorder for years?
Yes. ERP can help people who have experienced panic disorder for years, including those who have tried other approaches without getting the results they wanted. Treatment focuses on changing patterns of fear, avoidance, and safety behaviors that may be keeping panic disorder going.
Do I have to intentionally cause panic attacks during ERP?
Not necessarily. ERP may include exercises that intentionally bring on feared physical sensations, but the purpose isn't simply to cause panic attacks. Exercises are selected collaboratively and tailored to your fears, goals, and medical circumstances.
Can online ERP therapy help with agoraphobia?
Yes. Online ERP can help people with agoraphobia gradually approach situations they've been avoiding, such as leaving home, shopping, traveling, or going places independently. Virtual treatment can be especially accessible when getting to a therapist's office is difficult.
What if I have a panic attack during an online therapy session?
If panic occurs during a session, we can use the experience to practice responding differently to the sensations, when clinically appropriate. Rather than automatically trying to stop the panic, we work on reducing the fear and behaviors that keep you feeling controlled by it.
Where can I receive online ERP therapy for panic disorder?
Regnier Restorative Counseling offers virtual ERP therapy for adults physically located in Virginia, Washington DC, Maryland, Indiana, and Michigan. In-person therapy is also available in Reston, Virginia.
Looking for Online ERP Therapy for Panic Disorder?
If you've spent years trying to stop panic attacks but still live in fear of having another one, you may be ready for a different approach.
Maybe you're tired of constantly monitoring your body, avoiding certain places, or planning your life around the possibility of panicking.
I'm Kate Moore (Regnier), LCSW, and I specialize in helping adults with panic disorder and agoraphobia stop fearing panic through Exposure and Response Prevention (ERP) therapy.
Rather than teaching you more ways to control panic, we'll work on changing how you respond to it so you can get back to driving, traveling, going places, and enjoying your life.
I offer online ERP therapy for panic disorder and agoraphobia throughout Virginia, Washington DC, Maryland, Indiana, and Michigan, as well as in-person therapy in Reston, VA.
If you're ready to stop letting the fear of another panic attack dictate what you do, I'd love to help.
Learn more about online ERP therapy for panic disorder or contact Regnier Restorative Counseling to schedule a consultation.
