The maintenance of fluency after intensive in-patient therapy: Long-term follow-up

Maintenance of fluency after intensive in-patient treatment was studied in eight male stammerers. Reasons for success and failure are discussed in relation to objective and subjective data collected at the final follow-up interview.     

Long-term stability of cognitive behavioral therapy effects for panic disorder with agoraphobia: A two-year follow-up study

Objective

Cognitive-behavioral therapy (CBT) aims to help patients establish new behaviors that will be maintained and adapted to the demands of new situations. The long-term outcomes are therefore crucial in testing the durability of CBT.

Method

A two-year follow-up assessment was undertaken on a subsample of n = 146 PD/AG patients from a multicenter randomized controlled trial. Treatment consisted of two variations of CBT: exposure in situ in the presence of the therapist (T+) or on their own following therapist preparation (T−).

Results

Both variations of CBT had high response rates and, overall, maintained the level of symptomatology observed at post-treatment with high levels of clinical significance. Effect sizes 24 months following treatment were somewhat lower than at the 6-month follow up. Once patients reached responder status, they generally tended to remain responders at subsequent assessments. Differences were observed for patients that obtained additional treatment during the follow-up period. Expert opinion and subjective appraisal of treatment outcome differed. No robust baseline predictors of 2-year outcome were observed.

Conclusion

Most patients maintain clinically meaningful changes two years following treatment across multiple outcome measures. Approximately 1/3 of patients continued to experience meaningful residual problems.     

Long-term follow-up of a childhood amnesic syndrome

In attempting to explain observed dissociations between impaired and preserved memory functioning in amnesia, various dichotomous memory systems (e.g., procedural versus declarative, episodic versus semantic, working versus reference memory) have often been employed. In such cases, the assumption has been that memory subserved by one system is preserved, while that of the other system is impaired. Cohen and Squire have suggested that in amnesia, declarative memory is impaired, although procedural memory is preserved. Long-term follow-up of a densely amnesic patient refutes this view by demonstrating significant anterograde learning of school subjects including reading, vocabulary, spelling, and arithmetic, all of which include some component of declarative memory. It appears that the procedural/declarative dichotomy is not adequate to explain preserved memory in amnesia.     

A maintenance program for behavioral treatment of anxiety disorders

A maintenance program for behavioral treatments of anxiety disorders is presented in some detail, together with preliminary results of its application as part of three treatment trials. Compared to previous studies reporting long-term effects of behavioral treatments, the present program yielded a larger percentage of improvement during the follow-up period, a lower proportion of patients needing further treatment, and fewer relapses.