When using a cognitive-behavioral approach with a client experiencing agoraphobia and panic attacks, which technique is best for the initial session?

The most appropriate technique for the initial session when using a cognitive-behavioral approach with a client experiencing agoraphobia and panic attacks is the use of relaxation techniques. This technique serves to establish a sense of safety for the client and to help them manage their anxiety symptoms effectively.

At the initial stages of therapy, the client may be feeling overwhelmed and apprehensive about discussing their fears or entering feared situations. Relaxation techniques, such as deep breathing exercises or progressive muscle relaxation, can help to reduce immediate anxiety and provide tools the client can use to cope with distressing thoughts and physical sensations associated with panic attacks.

Additionally, these techniques help build rapport and trust between the therapist and the client, creating a supportive environment where the client feels comfortable exploring their experiences. Once the client has developed some skills for managing anxiety through relaxation, the therapist can then gradually introduce other interventions, such as exposure therapy, journaling, or social skills training, in subsequent sessions.