Treatment of obsessive-compulsive patients: The contribution of self-instructional training to the effectiveness of exposure

Fifteen obsessive-compulsive patients were given treatment consisting of ten sessions of gradual exposure in vivo. For half of the patients gradual exposure in vivo was preceded by self-instructional training.Treatment resulted in significant improvement on anxiety and avoidance scales, Leyton Obsessional Inventory, Self-rating Depression Scale and on ratings for anxious mood and depression. Neither the post-test nor the follow-ups 1 month and 6 months later indicated a difference between the effects of the two conditions. Self-instructional training did not enhance the effectiveness of gradual exposure in vivo.     

A psychoanalytic reinterpretation of the effectiveness of systematic desensitization: Fact or fiction?

Silverman, Frank and Dachinger (1974) found support for their hypothesis that the effectiveness of systematic desensitization (SD) resides in its activation of unconscious, merging fantasies. Their subjects were subjected to a variant of SD. in which a procedure aimed at stimulating a fantasy of ‘merging with mother’ was substituted for muscle relaxation. This pro- cedure consisted of the tachistoscopic subliminal exposure of the symbiotic gratification stimulus mommy and i are one(experimental) or neutral stimulus people walking (control). The aim of the present study was to replicate their work with special reference to demand characteristics. using as subjects snake phobics. SD with a symbiotic gratification stimulus was not more effective than SD with a neutral stimulus, which may be explained by the fact that the neutral stimulus in the present study snake and I are one was more relevant than the neutral stimulus in the Silverman et al. study. Moreover, subjects with a therapy-set improved significantly more than subjects with a research-set.     

Exposure and response prevention in the natural environment: A comparison with obsessive-compulsive patients

Thirteen obsessive-compulsive clients were treated with different methods of response prevention. Four experimental conditions were obtained through a 2 × 2 factorial design, in which the two main variables were varied: (1) gradual treatment vs flooding; and (2) modeling vs no-modeling. Clients were treated at their homes, three times weekly. Each session lasted 2 hr. Results at the post-test revealed, that modeling was superior to no-modeling (p < 0.05) on avoidance-other compulsions, therapist-rating only. On anxiety-main compulsions, clients rating the gradual method of treatment had been superior to flooding (p < 0.05). No other significant differences were found.     

Therapist-controlled exposure in vivo versus self-controlled exposure in vivo: A comparison with obsessive-compulsive patients

Fourteen obsessive-compulsive clients were given treatment consisting of ten sessions of gradual exposure in vivo With half the clients, the exposure in vivo was therapist-controlled; with the other half, the exposure in vivo was self-controlled.

The results of the posttest showed that both versions of the treatment resulted in a significant improvement on the in vivo measurement, anxiety and avoidance scales, Leyton Obsessional Inventory, Self-Rating Depression Scale and anxious mood. Neither the posttest nor the follow-ups one month and 3.5 months later indicated a difference between the effects of the two conditions. Self-controlled exposure in vivo proved to be as effective as therapist-controlled exposure in vivo, in spite of the fact that in the latter condition each treatment session lasted twice as long as in the former condition.     

Self-observation versus flooding in the treatment of agoraphobia

The effects on agoraphobia of (1) self-observation with a minimum of therapeutic intervention. (2) flooding, (3) a combination of flooding and self-observation, and (4) no-treatment control were compared. Assessments were made at the beginning of treatment, during and at the end of treatment and at the follow-up three months later. They were carried out by the therapist (in vivo) measurement; phobic anxiety and phobic avoidance scale) by an independent observer (phobic anxiety scale and phobic avoidance scale) and by the client (phobic anxiety scale; phobic avoidance scale: FSS; social anxiety scale; SDS and I-E scale).Self-observation, flooding and flooding/self-observation resulted in significant improvement on several variables, whereas the no-treatment control group did not improve. No difference in effectiveness was found between the self-observation and flooding treatments. In addition, the results suggest that a combined flooding/self-observation treatment is more effective than each of the individual treatments.