 220 PANIC/AGORAPHOBIA CLIENT PRESENTATION 1. Severe Panic Symptoms (1) * A. The client has experienced sudden and unexpected severe panic symptoms that have occurred repeatedly and have resulted in persistent concern about additional attacks. B. The client h as significantly modified his/her normal behavior patterns in an effort to avoid panic attacks. C. The frequency and severity of the panic attacks have diminished significantly. D. The client reported that he/she has not experienced any recent panic atta ck symptoms. 2. Fear of Environmental Situations Triggering Anxiety (2) A. The client described fear of environmental situations that he/she believes may trigger intense anxiety symptoms. B. The client's fear of environmental situations has resulted in his/her avoidance behavior directed toward those environmental situations. C. The client has a significant fear of leaving home and being in open or crowded public situations. D. The client's phobic fear has diminished, and he/she has left the home envir onment without being crippled by anxiety. E. The client is able to leave home normally and function within public environments. 3. Recognition That Fear Is Unreasonable (3) A. The client's phobic fear has persisted in spite of the fact that he/she ackno wledges that the fear is unreasonable. B. The client has made many attempts to ignore or overcome his/her unreasonable fear, but has been unsuccessful. 4. Increasing Isolation (4) A. The client described situations in which he/she has declined involveme nt with others due to a fear of traveling or leaving a safe environment, such as his/her home. B. The client reported that he/she has become increasingly isolated due to his/her fear of traveling or leaving a safe environment. C. The client has severely constricted his/her involvement with others. D. Although the client experiences some symptoms of panic, he/she still feels capable of leaving home. E. The client has been able to leave his/her safe environment on a regular basis. * The numbers in parentheses correlate to the number of the Behavioral Definition statement in the companion chapter with the same title in The Severe and Persistent Mental Illness Treatment Planner, 2nd ed. (Berghuis and Jongsma) by John Wiley & Sons, 2008. 