1. Marlene's repeated episodes of chest pain, trouble breathing, heavy sweating and dizziness, feelings of impending doom, constant rumination, and fear of recurrence of symptoms are indicative of the presence of Panic Disorder. According to the DSM-IV TR, for the diagnosis, essentially, repeated and unexpected panic attacks are followed by at least a month of persistent worry about having another panic attack, accompanied by worry about the possible consequences of these attacks, or by a significant behavioral change linked to the attacks. These attacks are not caused by the direct physiological effects of a substance or general medical condition, nor are they justified by the presence of any other mental disorder. Because recurrent panic attacks are accompanied by anxiety about being in places from which escape may be difficult or help may not be available (being out of the house alone, driving), Marlene would be diagnosed with panic disorder, with agoraphobia (300.21). The DSM V lists both disorders as separate diagnoses.2. According to the cognitive model, an individual's emotions, behavior and physiology are influenced by his perception of events. In other words, the way one interprets or interprets an event or situation determines the subsequent feeling aroused by that thought. Shaping your thinking in a realistic and adaptive way leads to improvements in mood, behavior and beliefs. The cognitive behavioral model of panic proposes that fear is a natural and adaptive response to perceived threat, in which the fight-or-flight response when danger is identified is activated to ensure survival. Panic, however, is seen as a learned response, where an individual's "fear of fear", i.e. the physiological changes that occur... middle of paper..., would be reduced through toleration of feared situations and understanding fear. response as normal. Therefore, safety behaviors such as breathing or drinking would be excluded from use during exposure exercises and phased out if present. Sessions 7-10 would be spaced out once every 2 weeks. We would like to emphasize relapse prevention and attention to strengthening therapeutic goals, emphasizing the management and not the elimination of anxiety as the optimal outcome of the therapeutic process. We will review learning, address challenging situations, and focus on honing new coping skills. If necessary, imagery, progressive muscle relaxation, controlled breathing would be taught in initial sessions and as HW, and systematic desensitization (with exposure) and distraction techniques would be incorporated into the therapy. After the 15th session, a monthly follow-up would be done..