2001•The British Journal of PsychiatryOpen access

Two-year follow-up after a randomised controlled trial of self- and clinician-accompanied exposure for phobia/panic disorders

Je‐Min Park, David Mataix‐Cols, Isaac M Marks, Thienchai Ngamthipwatthana, Melanie Marks, Ricardo Araya, Tarik Al-Kubaisy

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Abstract

BACKGROUND: Long-term follow-up has rarely been reported after self-exposure therapy for phobias. AIMS: Completion of such a follow-up. METHOD: Two-year follow-up was achieved in 68 (85%) of 80 patients with phobias who had completed a previous 14-week randomised controlled trial comparing therapist-accompanied self-exposure, self-exposure or self-relaxation. Measures were self-reported ratings of symptoms, satisfaction and use of other treatment. RESULTS: Improvement at week 14 was maintained 2 years later. Clinician-accompanied exposure and self-exposure did not differ on any measure. Compliance with self-exposure homework during weeks 0-8 predicted more improvement 2 years later. Patients who failed to improve with relaxation by week 14 improved after subsequent crossover to exposure. A need for more treatment for their phobias was still felt by 33 patients (49%). CONCLUSIONS: Patients with phobias maintained their improvement to 2-year follow-up after the end of self-exposure therapy.

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BACKGROUND: Long-term follow-up has rarely been reported after self-exposure therapy for phobias. AIMS: Completion of such a follow-up. METHOD: Two-year follow-up was achieved in 68 (85%) of 80 patients with phobias who had completed a previous 14-week randomised controlled trial comparing therapist-accompanied self-exposure, self-exposure or self-relaxation. Measures were self-reported ratings of symptoms, satisfaction and use of other treatment. RESULTS: Improvement at week 14 was maintained 2 years later. Clinician-accompanied exposure and self-exposure did not differ on any measure. Compliance with self-exposure homework during weeks 0-8 predicted more improvement 2 years later. Patients who failed to improve with relaxation by week 14 improved after subsequent crossover to exposure. A need for more treatment for their phobias was still felt by 33 patients (49%). CONCLUSIONS: Patients with phobias maintained their improvement to 2-year follow-up after the end of self-exposure therapy.

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Available abstract

BACKGROUND: Long-term follow-up has rarely been reported after self-exposure therapy for phobias. AIMS: Completion of such a follow-up. METHOD: Two-year follow-up was achieved in 68 (85%) of 80 patients with phobias who had completed a previous 14-week randomised controlled trial comparing therapist-accompanied self-exposure, self-exposure or self-relaxation. Measures were self-reported ratings of symptoms, satisfaction and use of other treatment. RESULTS: Improvement at week 14 was maintained 2 years later. Clinician-accompanied exposure and self-exposure did not differ on any measure. Compliance with self-exposure homework during weeks 0-8 predicted more improvement 2 years later. Patients who failed to improve with relaxation by week 14 improved after subsequent crossover to exposure. A need for more treatment for their phobias was still felt by 33 patients (49%). CONCLUSIONS: Patients with phobias maintained their improvement to 2-year follow-up after the end of self-exposure therapy.

Key concepts: Phobias, Exposure therapy, Specific phobia, Panic, Phobic disorder, Medicine, Crossover study, Anxiety

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