Although there is a growing body of research to support the
use of psychological treatments for specific disorders, there
has been no way for practitioners to provide feedback to
researchers on the barriers they encounter in implementing
these treatments in their day-to-day clinical work. In
order to provide practitioners a means to give researchers
information about their clinical experience, the Society of
Clinical Psychology and the Division of Psychotherapy of
the American Psychological Association collaborated on an
initiative to build a two-way bridge between practice and
research. A questionnaire was developed on the therapist,
patient, and contextual variables that undermine the
effective use of CBT in reducing the symptoms of panic
disorder, a clinical problem that occurs frequently in clinical
practice and has an extensive research base. An Internetbased
survey was advertised internationally in listservs and
professional newsletters, asking clinicians to indicate all
aspects of CBT that they used in treating panic disorder, and
to respond to a series of questions with variables that
presumably limited successful symptom reduction in clinical
work using CBT to treat panic disorder. The final database
included responses from 338 participants who varied in
experience in applying CBT to the treatment of panic
disorders. Participants identified a wide range of patient
factors that were barriers to symptom reduction, including
symptoms related to panic, motivation, social system,
and the psychotherapy relationship, in addition to specific