PROTOCOL OUTLINE: During the first 4 weeks of study, patients meet with a clinical nurse specialist once a week for approximately 1 hour. During this time, the nature of the anxiety disorder is explained and exposure to previously feared situations is encouraged.

Only patients who remain symptomatic at a stable level following self-exposure will proceed with rehabilitation training.

Patients meet with a physical therapist once a week for 4 weeks to further evaluate the extent of problems associated with balance. Then, patients undergo weekly 1 hour exercises for 8 weeks with the physical therapist, focusing on sensation, head and eye coordination, movement with eyes opened and closed, and gait.

Concurrently, patients meet with the clinical nurse specialist every 4 weeks during and after physical therapy to evaluate the effects of vestibular treatment on anxiety symptoms.

Training is continued if patient is symptomatic; otherwise, patient is discharged from study.

• Diagnosed panic disorder with or without agoraphobia
• Vestibular dysfunction, as defined by abnormalities in the caloric and/or rotational tests
• Continued symptomatology after general instructions of the importance of exposure to feared situations
• Absence of acute symptoms of anxiety or depression assessed to need immediate clinical care