The effects of prolonged exposure to phobic situations upon agoraphobic patients treated in groups

Nineteen female agoraphobic patients were treated by exposure to imaginal and real phobic stimulation in groups. There were three groups, including 7, 5 and 6 patients respectively, and each group received 9 hr of treatment spread over three sessions. The first two treatment hours of the first two sessions were arranged as a crossover design, patients being randomly allocated at the first session to imaginal or reality treatment for an hour followed by the other treatment for an hour, and receiving the treatments in reverse order at the second session. On both occasions there was a third hour of treatment after 1 hr unstructured group discussion over lunch. Psychological and behavioural measures were made before and after each part of treatment, and at follow-up 5 months after treatment.

Patients were significantly helped by this procedure. Practice sessions were associated with much more improvement than imaginal ones, and there was also an order effect, the first treatment received on each treatment day being more effective than the second. Group discussion over lunch did not improve the patient's phobias. The implications of these findings are discussed.