Öst and Westling (1995) – Cognitive Behavioural Therapy

Öst, Lars-Göran, and Bengt E. Westling. “Applied relaxation vs cognitive behavior therapy in the treatment of panic disorder.” Behaviour Research and Therapy 33.2 (1995): 145-158.



This is the third study we will be looking at from the ‘Treatments of Dysfunctional Behaviour’ section of ‘Dysfunctional Behaviour’, as part of your OCR A2 Health and Clinical Psychology course. It is further categorised into ‘Cognitive Treatment.




Ost and Westling (1995) –  used a longitudinal study to compare the effects of cognitive behavioural therapy and applied relaxation. It was found that both are equally effective.


To compare cognitive behaviour therapy (CBT) with applied relaxation as therapies for panic disorder.

Method and Design

A longitudinal study with patients undergoing therapy for panic disorder.

Independent measures design with patients being randomly assigned to either applied relaxation or cognitive behavioural therapy.


38 patients with DSM diagnosis of panic disorder, with or without agoraphobia.  Recruited through referrals from psychiatrists and newspaper advertisements.

26 females and 12 males, mean age 32.6 years (range 23–45 years). From a variety of occupations and some married, some single and some divorced.


Pre-treatment: baseline assessments of panic attacks, using a variety of questionnaires.

Patients recorded details of every panic attack in a diary.

Each patient was then given 12 weeks of treatment at 50–60 minutes per week, with homework to carry out between appointments. 

Applied relaxation was used to identify what caused panic attacks, and then relaxation training started with tension-release of muscles. This was gradually increased so that by session 8 rapid relaxation was used and patients were able to practise their techniques in stressful situations.

Cognitive Behavioural Therapy was used to first identify the misinterpretation of physical symptoms and then to generate an alternative cognition in response.

For example, not to feel panic when something stressful happened, but to come up with an alternative explanation. To give an example:  my heart racing is not a heart attack but a normal physical reaction to stress and it will slow down in a minute.

This was then tested in situations where participants had panic situations induced, but were not allowed to avoid them, so that eventually they had to accept that their restructured thoughts were right.

Patients were then reassessed on the questionnaires.

After one year a follow up assessment using the questionnaires was carried out.


Applied relaxation showed 65% panic-free patients after the treatment, 82% panic-free after one year.

Cognitive behavioural therapy showed 74% panic-free patients after the treatment and 89% panic-free after a year.

These differences were not significant.

Complications such as generalised anxiety and depression were also reduced to within the normal range after one year.


Both Cognitive behavioural therapy and applied relaxation worked at reducing panic attacks, but it is difficult to rule out some cognitive changes in the applied relaxation group even though this is not focused on in this research.

Öst and Westling (1995) – Evaluation

+ Longitudinal – the use of a longitudinal study allows the researchers to see the development of the treatment, this was particularly important in this case.

– Sample size – as the study was longitudinal the sample was small, this means it is difficult to generalise the results to wider populations. However, a great deal of detail was collected on the participants.

+ Usefulness – the study is useful because it shows that both cognitive behavioural therapy and applied relaxation are effective, therefore the patient should choose the cheapest method.


Öst, Lars-Göran, and Bengt E. Westling. “Applied relaxation vs cognitive behavior therapy in the treatment of panic disorder.” Behaviour Research and Therapy 33.2 (1995): 145-158.

Further Reading

OCR A2 Psychology Student Unit Guide New Edition: Unit G543 Health and Clinical Psychology (Student Unit Guides)

Psych Yogi’s Top Ten Psychology Revision Tips for the A* Student

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Öst and Westling (1995) - Cognitive Behavioural Therapy
'Treatments of Dysfunctional Behaviour' section of 'Dysfunctional Behaviour' part of your OCR A2 Health & Clinical Psychology course. Revise Cognitive Treatment

One thought on “Öst and Westling (1995) – Cognitive Behavioural Therapy

  1. I would like to thank you first for giving us such a valuable information regarding the Cognitive Behavioural Therapy.
    I am really very grateful to you for sharing such an information with us.

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