Smartphone-based videoconferencing for the treatment of panic disorder and agoraphobia: A case illustration of a real-time guided exposure therapy

Exposure therapy is widely recognized as the treatment of choice for disorders characterized by fear, anxiety, and avoidance. Despite its well-established efficacy, many cognitive-behaviourally oriented therapists refrain from using this approach in routine practice due to attitudinal or logistical barriers. Identifying effective ways to implement exposure techniques is therefore essential to achieving more favourable therapeutic outcomes. Technological advances have introduced flexible options for psychotherapy, allowing effective delivery beyond traditional face-to-face settings. In this context, remote exposure therapy conducted in clients’ real-life environments may offer significant advantages for both therapists and clients. Although the effectiveness of video-conference–delivered therapies for various disorders has been documented, practical illustrations of how to conduct exposure-based interventions remain limited. This article presents an exposure protocol delivered to a client with panic disorder and agoraphobia (PDA) across 10 sessions, most of which were implemented in an intensive format. The case demonstrates how one of the major barriers to exposure—avoidance and safety behaviours—can be systematically reduced and ultimately eliminated through therapist-guided, optimally balanced interventions informed by contemporary theoretical frameworks.