Hope in Record Time: 4-Day Therapy Reduces Panic Attacks

Panic disorder causes sudden attacks of intense fear, with physical symptoms such as shortness of breath and a racing heart. A recent treatment called the Bergen 4-Day Treatment (B4DT), which provides intensive therapy over just four days, has shown very positive results: more than 80% of patients were symptom-free even a year later. This approach can be an effective, fast and affordable solution for those suffering from the disorder.

Panic disorder (PD) is a type of anxiety disorder that causes sudden and intense attacks of fear. These episodes are often accompanied by physical symptoms such as a racing heart, rapid breathing, excessive sweating, shaking and dizziness.

After experiencing these attacks, many people begin to worry excessively about the possibility of having another episode, which can seriously affect their routine and quality of life.

This disorder can make it difficult to work, have relationships and overall well-being, especially when it is accompanied by agoraphobia, the fear of being in places that would be difficult to escape in the event of an attack.

Studies show that around 1.7% of people worldwide will experience this disorder at some point in their lives, with the highest numbers in Western Europe and North America. In addition, 80% of people with panic disorder also have other psychological problems, such as depression or other types of anxiety.

Fortunately, there are effective treatments. One of the main ones is Cognitive Behavioral Therapy (CBT), which helps people understand and deal with their thoughts and behaviors in relation to fear and anxiety. Research indicates that Cognitive Behavioral Therapy is quite effective for both cases with and without agoraphobia, even when applied in private practices or in a more intensive way.

The intensive form can help the patient recover faster, return to work and reduce the chances of dropping out of treatment. In addition to Cognitive Behavioral Therapy, the use of certain medications, such as selective serotonin reuptake inhibitors (SSRIs), also shows good results.

A new form of Cognitive Behavioral Therapy called the “Bergen 4-Day Treatment” (or B4DT) has shown great promise. It was originally used to treat obsessive-compulsive disorder (OCD) and is also being used to treat social phobia and panic disorder.

B4DT is delivered over four consecutive days, during which small groups of patients (usually 3 to 6) receive intensive care from trained therapists. The main focus is on exposure with response prevention, meaning that patients face their fearful situations in a planned way, with close and ongoing support from therapists, but without engaging in avoidance behaviors.

The method is highly structured and personalized, with hands-on intervention from day one. In addition, therapists use a close-coaching model to maintain engagement and promote rapid change. Studies show that this approach leads to rapid symptom reduction, with high remission rates maintained up to a year after treatment, even in settings with limited mental health resources.

In a study of 58 people living in rural Norway, for example, more than 80% of patients were in remission (i.e., without significant symptoms) three months after treatment.

The new study analyzed sought to understand whether the good results of B4DT were maintained even after one year. The same 58 patients from the previous study were followed for 12 months.

The researchers used specific questionnaires to measure symptoms of panic, depression and generalized anxiety.

The results were encouraging: 82.8% of participants remained in remission after one year, and there were also significant improvements in symptoms of depression and anxiety.

These findings show that B4DT can be an effective and long-lasting alternative to treat panic disorder, especially in regions where access to conventional treatments may be more difficult, such as in rural areas.

This concentrated form of therapy has the potential to be more widely used, helping more people recover their quality of life quickly and effectively.

READ MORE:

The Bergen 4-Day Treatment for panic disorder patients in a rural clinical setting: a long-term follow-up study. 

Thorstein Olsen Eide, Thorbjørn Olsen, Hans Hansen, Bjarne Hansen, Stian Solem, and Kristen Hagen

BMC Psychiatry 25, 3 (2025). 

https://doi.org/10.1186/s12888-024-06445-0

Abstract:

The Bergen 4-Day Treatment (B4DT) is a concentrated cognitive behaviour therapy (CBT) approach that has shown promise in treating panic disorder (PD). However, the effectiveness of the B4DT, particularly regarding long-term outcomes in rural clinical settings, remains underexplored. A total of 58 patients were included using a naturalistic open-label trial design. Patients were assessed at 12-month follow-up. Measures included the Panic Disorder Severity Scale (PDSS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 scale (GAD-7). The study revealed significant and lasting reductions in PD symptoms, with a high rate of remission maintained at 12-month follow-up (82.8%). Regarding the secondary outcomes, significant improvements in symptoms of depression and generalized anxiety were also shown. The B4DT represents a promising treatment approach for PD, demonstrating stable long-term outcomes in rural settings. This finding supports the potential of concentrated CBT formats in achieving sustained symptom improvement in patients with PD, warranting further investigation and broader implementation. The study was reviewed by the Regional Committee for Medical Research Ethics Northern Norway, REK North (REK Nord2021/273145).