One-session group therapy of spider phobia: direct versus indirect treatments.

Forty-six patients with spider phobia, fulfilling the DSM-IV criteria for specific phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to three group treatment conditions: (1) direct treatment; (2) direct observation; and (3) indirect observation. All treatments were carried out in large groups of eight patients, and consisted of one 3 hr session of massed exposure and modelling. The results showed that on the behavioral test, measures and the specific self-report measures of spider phobia the direct treatment was significantly better than direct observation and indirect observation, which did not differ. On the physiological measures and the psychopathology self-report measures there were significant pre-post improvements, but no differences between the groups. The effects were maintained or furthered at the one year follow-up assessment. The proportion of clinically significantly improved patients were, at post-treatment, 75% in the direct treatment, 7% in the direct observation, and 31% in the indirect observation group. At follow-up, the corresponding figures were 75, 14, and 44%, respectively. The conclusion that can be drawn is that direct treatment is the treatment of choice.

[1]  Lars-Göran Öst,et al.  One-session treatment for specific phobias. , 1989, Behaviour research and therapy.

[2]  P. Lang,et al.  Psychometric description of some specific-fear questionnaires. , 1974 .

[3]  S. Williams,et al.  Guided mastery and performance desensitization treatments for severe acrophobia. , 1985, Journal of consulting and clinical psychology.

[4]  A. Arntz,et al.  Does Stimulus Elaboration Potentiate Exposure in vivo Treatment? Two Forms of One-Session Treatment of Spider Phobia , 1993, Behavioural Psychotherapy.

[5]  N. Jacobson,et al.  Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance , 1984 .

[6]  D. Chambless,et al.  Spacing of exposure sessions in treatment of agoraphobia and simple phobia , 1990 .

[7]  B. Burns,et al.  Gender differences in phobias: Results of the ECA community survey , 1988 .

[8]  M. Kozak,et al.  Emotional processing of fear: exposure to corrective information. , 1986, Psychological bulletin.

[9]  A Bandura,et al.  Relative efficacy of desensitization and modeling approaches for inducing behavioral, affective, and attitudinal changes. , 1969, Journal of personality and social psychology.

[10]  C. Thoresen,et al.  Effects of modeling and desensitization in reducing dentist phobia. , 1974 .

[11]  Isaac Marks.  Fears, phobias, and rituals , 1987 .

[12]  W. Agras,et al.  The natural history of phobia. Course and prognosis. , 1972, Archives of general psychiatry.

[13]  H. Wittchen.  Der Langzeitverlauf unbehandelter Angststrungen: Wie hufig sind Spontanremissionen? , 1991 .

[14]  Lars-Göran Öst.  A maintenance program for behavioral treatment of anxiety disorders. , 1989 .

[15]  R. Gatchel.  Effectiveness of two procedures for reducing dental fear: group-administered desensitization and group education and discussion. , 1980, Journal of the American Dental Association.

[16]  Lars-Göran Öst,et al.  One-session therapist directed exposure vs two forms of manual directed self-exposure in the treatment of spider phobia. , 1995, Behaviour research and therapy.

[17]  Lars-Göran Öst,et al.  One-session group treatment of spider phobia , 1996 .

[18]  Lars-Göran Öst,et al.  One versus five sessions of exposure in the treatment of flying phobia. , 1997, Behaviour research and therapy.

[19]  Windy Dryden,et al.  Handbook of Psychotherapy and Behavior Change , 1987, Journal of Cognitive Psychotherapy.

[20]  Lars-Göran Öst,et al.  One versus five sessions of applied tension in the treatment of blood phobia. , 1996, Behaviour research and therapy.

[21]  A. Bandura.  Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[22]  A. Liddell,et al.  The effect of concordance in the treatment of clients with dental anxiety. , 1991, Behaviour research and therapy.

[23]  A. Beck,et al.  An inventory for measuring clinical anxiety: psychometric properties. , 1988, Journal of consulting and clinical psychology.

[24]  S. Murphy,et al.  The nature and treatment of fear of flying: A controlled investigation , 1983 .

[25]  D. Bernstein,et al.  Multiple approaches to the reduction of dental fear. , 1982, Journal of behavior therapy and experimental psychiatry.

[26]  Lars-Göran Öst,et al.  One versus five sessions of exposure in the treatment of injection phobia , 1992 .

[27]  Lars-Göran Öst,et al.  One-session therapist-directed exposure vs. self-exposure in the treatment of spider phobia * , 1991 .

[28]  B. Ritter.  The use of contact desensitization, demonstration-plus-participation and demonstration-alone in the treatment of acrophobia. , 1969, Behaviour research and therapy.

[29]  N. Brooks,et al.  Stress Control: A Controlled Comparative Investigation of Large Group Therapy for Generalized Anxiety Disorder , 1992, Behavioural Psychotherapy.

[30]  R. Higgins,et al.  A comparison of negative practice and systematic desensitization in the treatment of acrophobia. , 1983, Journal of behavior therapy and experimental psychiatry.

[31]  A Bandura,et al.  Cognitive processes mediating behavioral change. , 1977, Journal of personality and social psychology.

[32]  J. Gauthier,et al.  Flooding and coping skills training in the management of dental fear , 1985 .

[33]  L. Rehm,et al.  The contribution of relaxation to symbolic modeling in the modification of dental fears. , 1977, Behaviour research and therapy.

[34]  F. Watts,et al.  Questionnaire dimensions of spider phobia. , 1984, Behaviour research and therapy.

[35]  P. Lang,et al.  A FEAR SURVEY SCHEDULE FOR USE IN BEHAVIOUR THERAPY. , 1964, Behaviour research and therapy.

[36]  B. Ritter.  Treatment of acrophobia with contact desensitization. , 1969, Behaviour research and therapy.

[37]  Lars-Göran Öst,et al.  Individual response patterns and the effects of different behavioral methods in the treatment of claustrophobia. , 1982, Behaviour research and therapy.

[38]  A. Beck,et al.  Depression: Causes and Treatment , 1967 .