Effects of therapist-guided exposure in CBT for panic disorder and agoraphobia
Thomas Lang, Sylvia Helbig-Lang, Andrew T. Gloster, Jan Richter, Alfons O. Hamm, Lydia Fehm, Thomas (2012)
Zeitschrift für Klinische Psychologie und Psychotherapie 41(2), 114-124
Abstract
Theoretical background: There is a paucity of studies examining the role of therapist guidance during in-vivo exposure for panic disorder with agoraphobia (PD/AG). A recent study (MAC-study) suggested superior effects of therapistguided exposure compared to programmed practice.
Objectives: Examining potential mechanisms of therapist-guided exposure.
Methods: Data from 301 patients with PD/AG who received either CBT with therapist guidance during in-vivo exposure (T+), or CBT with programmed exposure practice (T–) were analysed in regard to effects of initial symptom severity, subtle avoidance behaviours, reductions in fear of fear, and frequency of exposure homework.
Results: There were no interaction effects between symptom severity or subtle avoidance and outcome. T+ was associated with higher reductions in fear of fear as well as with higher frequency of exposure homework. Frequency of exposure homework mediated the effect of group on outcome.
Conclusion: Advantages of therapist-guided exposure as well as frequency of self-exposure might be attributed to higher reductions in fear of fear.
Categories: Angststörungen, Therapie
Keywords: exposure, panic disorder, agoraphobia, therapist guidance, programmed practice