Vol. 4 No. 2 (2022): July - Decembre 2022
Integrated therapy

Ansia e attacchi di panico, trattamento complesso: Interventi integrati nel trattamento dell’Ansia e degli attacchi di Panico

Priscilla Ciufo
Federica Leoni

Published 2022-12-02


  • Terapia online, Psicoterapia, Disturbi d’Ansia, Attacco di panico, Trattamento integrato, EMDR

How to Cite

Iannazzo, A., Ciufo, P., & Leoni, F. . (2022). Ansia e attacchi di panico, trattamento complesso: Interventi integrati nel trattamento dell’Ansia e degli attacchi di Panico. Phenomena Journal - International Journal of Psychopathology, Neuroscience and Psychotherapy, 4(2), 139–165. https://doi.org/10.32069/PJ.2021.2.178


From the onset of the Covid-19 pandemic to the present, the work of psychologists and psychotherapists has undergone major changes. The need to move from an in-person to an online setting, as well as the type of demands, coming from patients increasingly in a state of distress, have led helping relationship professionals to develop new settings and adaptations of online psychotherapy. The pandemic, disrupting the world we all knew, is having a heavy impact on the psychic sphere of individuals, causing, for example, a major increase in anxiety and panic disorders. Therefore, the article aims to present some tools that are useful to psychologists and psychotherapists, that can support them in working remotely with anxious patients, both synchronously and asynchronously. The integration of different techniques can help to range between different activities rooted in the most effective psychotherapeutic orientations, such as cognitive-behavioral theory and EMDR.


  1. Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman S., Kendler, K. S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry, 51(1), pp. 8-19.
  2. Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), pp. 593-602.
  3. AA.VV. (2020a, June 3). eHealth Network, Summary report. 17th e HealthNetwork meeting, Brussels.
  4. AA.VV. (2020b, March 18). Mental health and psychosocial considerations during the COVID-19 outbreak. Document, World Health Organization.
  5. Carriero, C. (2020). Smart working: Tool e attitudini per gestire il lavoro da casa e da remoto. Milano: Hoepli.
  6. Suler, J. (2001). The Future of Online Clinical Work. Journal of Applied Psychoanalytic Studies, 4, pp. 265-70.
  7. Suler, J. (2006). The psychology of cyberspace. www.rider.edu/users/suler/psycyber/psycyber.html
  8. McWilliams, N. (2020, April 5). Psychotherapy in a Pandemic. www.researchgate.net/publication/342491996.
  9. Catz, B. et al. (2020). Fear of lockdown. Psychoanalysis, pandemic discontents and climate change. Lecce: Frenis Zero.
  10. Bloom, J.W. (1998). The ethical practice of Web Counseling. British Journal of Guidance and Counselling, 26, 1, pp. 53-59.
  11. Van Daele, T., Karekla, M., Kassianos, A.P. et al. (2020). Recommendation for Policy and Practice of Telepsychotherapy and E-Mental health in Europe and Beyond. Journal of Psychotherapy Integration, 30 (2), pp. 160-173, (DOI: 10.1037/int0000218).
  12. Vargiu, N. (2021). Psicologia online: un’opportunità d’innovazione. Dueville: Ronzani RES.
  13. Algeri, D., Gabri, S., Mazzucchelli, L. (2018). Consulenza psicologica online. Esperienze pratiche, linee guida e ambiti di intervento. Giunti: Firenze.
  14. Iannazzo, A., Leoni, F., Ciufo, P. (2022). Psicoterapia online, come realizzare interventi efficaci a distanza. Roma: Carocci.
  15. Laliotis, D. (2020, November/December). Trauma and Teletherapy: discerning our clients’ needs, Psychotherapy Networker. New York: Routledge.
  16. Leoni, F. (2021, novembre). Psicoterapia online. Efficienza e risorse del servizio. In A. Iannazzo (a cura di), Consulenza e formazione online. Integrazione nelle Psicoterapie, 11, Roma: Aspic.
  17. Leoni, F., Ciufo, P. (2021). Psicologia online. Costruzione del setting e pratica clinica. In A. Iannazzo (a cura di), Consulenza e formazione online. Integrazione nelle Psicoterapie, 11, Roma: Aspic.
  18. Öst, L-G. (2008). Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behaviour Research and Therapy, 46, pp. 296-321.
  19. Norton, P.J., Price, E.P. (2007). A meta-analytic review of cognitive-behavioral treatment outcome across the anxiety disorders. Journal of Nervous and Mental Disease, 195, pp. 521–531.
  20. Burns, D.D., Auerbach, A. (1996). Therapeutic empathy in cognitive-behavioral therapy: Does it really make a difference? In P.M. Salkovskis (Ed.), Frontiers of cognitive therapy (pp. 135-164). New York: Guilford Press.
  21. Seligman, M.E.P., Walker, E.F., Rosenhan, D.L. (2001). Abnormal psychology (4th ed.). New York: W.W. Norton & Company.
  22. Giusti, E., Montanari, C., Iannazzo, A. (2004). Psicoterapie Integrate (nuova ed.). Milano: Masson.
  23. Giusti, E., Montanari, C., Iannazzo, A. (2021). Manuale. Psicoterapie Pluralistiche Integrate. Roma: Armando.
  24. Norton, P.J., Philipp, L.M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice, Training, 45(2), pp. 214–226. https://doi.org/10.1037/0033-3204.45.2.214https.
  25. Yerkes, R.M., Dodson, J.D. (1908). The relation of strength of stimulus to rapidity of habit-formation. Journal of Comparative Neurology and Psychology, 18 (5): pp. 459–482. doi:10.1002/cne.920180503.
  26. Selye, H. (1974). Stress without distress. Philadelphia: Lippincott.
  27. Selye, H. (1976). Stress in health and disease. Boston (MA): Butterworths.
  28. APA (American Psychiatric Association) (2014). DSM-5 – Manuale diagnostico e statistico dei disturbi di personalità (5ª ed.). Milano: Raffaello Cortina Editore (ed. or. 2013).
  29. Ellis, A., (2013). Che ansia! Come controllarla prima che lei controlli te. Trento: Erickson.
  30. Rogers, C. (1977). La terapia centrata sul cliente. Roma: Astrolabio (ed. or. 1951).
  31. Ellis, A., (1996). Sex Without guilt (new ed.). Pennsylvania State University: Wilshire Book Company
  32. Andrews, G., Creamer, M., Crino, R., Hunt, C., Lampe, L., Page, A. (2003).
  33. Trattamento dei disturbi d'ansia. Guide per il clinico e manuali per chi soffre del disturbo. Torino: Centro Scientifico Editore.
  34. Burns, D.D. (1980). Sentirsi bene. Milano: Mondadori.
  35. Yellowlees, P., Nakagawa, K., Pakyurek, M. et al. (2020, July). Rapid conversion of an outpatient Psychiatric Clinic to a 100% Virtual Telepsychiatric Clinic in response to COVID-19. Technology in Mental Health (DOI:10.1176/appi.ps.202000230).
  36. Zhao, X., Bhattacharjee, S. (2020). The impact of telemental health use on healthcare costs among commercially insured adults with mental health conditions. Current Medical Research and Opinion, 36 (9): pp. 1541-1548.
  37. Suler, J. (2017). Psychoanalytic Cyberpsychology. International Journal of Applied Psychoanalytic Studies, 14, pp. 97-102.
  38. Suler, J. (2004). The Online Disinhibition Effect. CyberPsychology and Behavior, 7, pp. 321-6.
  39. Christ, C., Schouten, M.J., Blankers, M. et al. (2020). Internet and Computer-based Cognitive Behavioral Therapy for Anxiety and Depression in Adolescents and Young Adults: A Systematic Review and Meta-analysis. Journal of Medical Internet Research, 22 (9), e17831, (DOI: 10.2196/17831).
  40. Lowen, A. (1975). Bioenergetics. New York: Coward, McCarin, Geoghen Inc.
  41. Beck, A.T., Emery, G. (1988). L’ansia e le fobie. Una prospettiva cognitiva. Roma: Astrolabio.
  42. Clark, D.M. (1986). A cognitive approach to panic. Behaviour research and Therapy, 24, pp. 461-470.
  43. Clark, D.M. (1988). A cognitive model of panic attacks. In S. Rachman, J.D. Maser (Eds.). Panic: Psychological Perspectives (pp. 71-89). Hillsdale (NJ): Erbaum.
  44. Clark, D.M., Salkovskis, P.M., Gelder, M.G., Koehler, C., Martin, M., Anastasiades, P. et al. (1988). Tests of a cognitive theory of panic. In I. Hand, H.U., Wittchen (Eds.). Panic and phobias 2. Berlin: Springer-Verlag.
  45. Wells, A. (1997). Cognitive Therapy of Anxiety Disorders: a practice manual and conceptual guide. Chichester: Wiley.
  46. Rees, C.S., Maclaine, E. (2015). A Systematic Review of Videoconference Delivered Psychological Treatment for Anxiety Disorders. Australian Psychologist, 50, 4, pp. 259-264.
  47. Williams, M., Penman, D. (2014). Metodo Mindfulness. 56 giorni alla felicità. Il programma di meditazione che ha liberato dall’ansia e dallo stress milioni di persone. Milano: Mondadori.
  48. Ivanowsky, B., Malhi, G.S. (2007). The Psychological and Neurophysiological Concomitants of Mindfullness Forms of Meditation. Acta Neuropsychiatrica, 19, pp. 76-91.
  49. Shapiro, S.L., Oman, D., Thoresen, C.E., Plante T.G., Flinders T. (2008). Cultivating Mindfullness. Effects on Well-Being. Journal of Clinical Psychology, 64(7), pp. 840-62.
  50. Shapiro, S.L., Schwatz, G.E., Bonner, G. (1998). Effects of Mindfullness-Based Stress Reduction on Medical and Premedical Students. Journal of Behavioral Medicine, 21, pp. 581-99.
  51. Baer, R.A., Smith, G.T., Hopkins, J., Kreitemeyer, J., Toney, L. (2006). Using Self-Report Assessment Methods to Explore Facets of Mindfullness. Assessment, 13, pp. 27-45.
  52. Hick, S.F., Segal, Z.V., Bien, T. (2008). Mindfullness and the Therapeutic Relationship. New York: Guilford Press.
  53. Iannazzo, A. (a cura di) (2021, novembre). Consulenza e formazione online. Integrazione nelle Psicoterapie, 11. Roma: Aspic.
  54. Shapiro, F. (2019). EMDR. Il manuale. Principi fondamentali, protocolli e procedure. Milano: Cortina.
  55. Zaccagnino, M., Callerame, C. (a cura di) (2022). Terapia EMDR. Attaccamento, concettualizzazione del caso e lavoro con le parti del Sé. Trento: Erickson.
  56. Croitoru, T. (2020). Emdr Revolution. Cambiare la propria vita un ricordo alla volta. Sesto San Giovanni: Mimesis.
  57. Manfrida, G., Albertini, V., Eisenberg, E. (2020). La clinica e il web: Risorse tecnologiche e comunicazione psicoterapeutica online. Milano: Angeli.
  58. Bauman, Z. (2000). Modernità liquida. Bari: Laterza.
  59. Mizrahi, C. (2017). The analyst’s closeness in long-distance psychoanalysis. In J. Sharf (Ed.), Psychoanalysis online 3, pp. 65-83. London: Karnac.
  60. Blumer, M., Hertleink, M., Vanderbosch, M. (2015). Towards the development of educational core competencies for couple and family therapy technology practices. Contemporary Family Therapy, 37, pp. 113-21.
  61. Wagner, B., Horn, A., Maercker, A. (2014). Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controller non-inferiority trial. Journal of Affective Disorders, 152, pp. 113-121.
  62. Wagner, C.S., Park, H.W., Leydesdorff, L. (2015). The Continuing Growth of Global Cooperation Networks in Research: A Conundrum for National Governments. Leuven, Belgium: Wolfgang Glanzel, Katholieke Universiteit.
  63. Chois, S., Schalet, B., Cook, K. F., Cella, D. (2014). Establishing a Common Metric for Depressive Symptoms: Linking the BDI-II, CES-D, and PHQ-9 to PROMIS Depression. Psychological Assessment, 26, 2, pp. 513–27.
  64. Yuen, E.K., Gros, D.F., Price, M., Zeigler, S., Tuerk, P.W., Foa, E.B., Acierno R. (2015). Randomized controlled trial of home-based telehealth versus in-person prolonged exposure for combat-related PTSD in veterans: Preliminary results. Journal of Clinical Psychology, 71, 6, pp. 500-12.
  65. Bandelow, B., Michaelis, S., Wedekind, D. (2017, Jun). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19(2): 93–107 (DOI: 10.31887/DCNS.2017.19.2/bbandelow).
  66. Bandelow, B., Sagebiel, A., Belz, M., Görlich, Y., Michaelis, S., Wedekind, D. (2018). Enduring effects of psychological treatments for anxiety disorders: meta-analysis of follow-up studies. British Journal of Psychiatry, 212, pp. 333–338.
  68. https://emdr.it/ (ultimo accesso, 29-09-2022)
  69. https://emdr-platform.it/ (ultimo accesso, 29-09-2022)
  70. https://www.psicologiapathos.it/lo-stress-conosciamolo-meglio/ (ultimo accesso, 21-09-2022)
  71. https://www.remotemdr.com/it/ (ultimo accesso, 29-09-2022)