Hostname: page-component-848d4c4894-x5gtn Total loading time: 0 Render date: 2024-05-05T14:41:09.634Z Has data issue: false hasContentIssue false

The Effects of Therapist Presence and Relaxation Training on the Efficacy and Generalizability of in vivo Exposure

Published online by Cambridge University Press:  16 June 2009

Peter G. AuBuchon
Affiliation:
The Institute of Pennsylvania Hospital
Karen S. Calhoun
Affiliation:
The University of Georgia

Extract

The present study examined the effects of therapist presence and the addition of relaxation training on the efficacy and generalizability of in vivo exposure procedures in the treatment of multiply-phobic individuals. Thirty-two individuals who were severely phobic of at least two objects/situations were assigned to one of three treatment groups or a waiting list control group, but received treatment for only one phobia. The Exposure Alone group received prolonged exposure to a phobic stimulus while alone in a room with that stimulus. The Exposure + Relaxation group were also exposed to a phobic stimulus but had received additional training in a relaxation technique. Subjects in the Exposure + Therapist group were accompanied by a nonanxious/nonavoiding “therapist” during exposure sessions. All treatment groups improved significantly, but the Exposure + Therapist group demonstrated significantly greater extinction of fear responses related to the treated phobias than the other groups. The Exposure + Relaxation group demonstrated the greatest generalization of treatment effects to untreated phobias. Clinical and theoretical implications are discussed.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychology Review, 84, 181215.CrossRefGoogle Scholar
Bandura, A. and Menlove, F. L. (1968). Factors determining vicarious extinction of avoidance behavior through symbolic modeling. Journal of Personality and Social Psychology, 8, 99108.CrossRefGoogle ScholarPubMed
Bandura, A., Blanchard, E. B. and Ritter, B. (1969). The relative efficacy of desensitization and modeling approaches for inducing behavioral, affective, and attitudinal changes. Journal of Personality and Social Psychology, 13, 173199.CrossRefGoogle ScholarPubMed
Baum, M. (1969). Extinction of an avoidance response motivated by intense fear: social facilitation of the action of response prevention (flooding) in rats. Behaviour Research and Therapy, 7, 5762.CrossRefGoogle ScholarPubMed
Baum, M. (1970). Extinction of avoidance responding through response prevention (flooding). Psychological Bulletin, 74, 276284.CrossRefGoogle ScholarPubMed
Bennett, B. M. and Nakamura, E. (1963). Tables for testing significance in a 2×3 contingency table. Techometrics, 5, 501511.Google Scholar
Borkovec, T. D. and Sides, J. (1979). The contribution of relaxation and expectancy to fear reduction via graded imaginal exposure to feared stimuli. Behaviour Research and Therapy, 17, 529540.CrossRefGoogle ScholarPubMed
Castellan, N. J. (1965). On the partitioning of contingency tables. Psychological Bulletin, 64, 330338.CrossRefGoogle ScholarPubMed
Crowe, M. J., Marks, I. M., Agras, W. S. and Leitenberg, H. (1972). Time-limited desentitization, implosion, and shaping for phobic patients: A crossover study. Behaviour Research and Therapy, 10, 319328.CrossRefGoogle ScholarPubMed
Emmelkamp, P. M. G. (1982). In vivo treatment of agoraphobia. In Agoraphobia: Multiple Perspectives on Theory and Treatment. Chambless, D. L., and Goldstein, A. J., (Eds). New York: John Wiley and Sons, Inc.Google Scholar
Emmelkamp, P. M. G. and Felton, M. (1985). The process of exposure in vivo: Cognitive and physiological changes during treatment of acrophobia. Behaviour Research and Therapy, 23, 219223.Google Scholar
Eysenck, H. J. and Eysenck, S. B. G. (1968). Eysenck Personality Inventory. Educational Industrial Testing Service, San Diego.Google Scholar
Ferguson, G. A. (1966). Statistical Analysis in Psychology and Education, 2nd edition. McGraw-Hill, New York.Google Scholar
Ghosh, A. and Marks, I. M. (1987). Self-treatment of agoraphobia by exposure. Behavior Therapy, 18, 316.CrossRefGoogle Scholar
Grayson, J. B., Foa, E. B. and Steketee, G. (1982). Habituation during exposure treatment: Distraction versus atention focusing. Behaviour Research and Therapy, 20, 323328.CrossRefGoogle Scholar
Gustavson, B., Jansson, L., Jerremalm, A. and Öst, L. G. (1985). Therapist Behavior during exposure treatment of agoraphobia. Behavior Modification, 9, 491504.CrossRefGoogle ScholarPubMed
Jansson, L., Jerremalm, A. and Öst, L. G. (1986). Follow-up of agoraphobic patients treated with exposure in vivo or applied relaxation. British Journal of Psychiatry, 149, 486490.CrossRefGoogle ScholarPubMed
Johnston, D. and Gath, G. (1973). Arousal levels and attribution effects in diazepam-assisted flooding. British Journal of Psychiatry, 123, 463466.CrossRefGoogle ScholarPubMed
Malleson, N. (1959). Panic and phobia: A possible method of treatment. Lancet, 1, 225227.CrossRefGoogle ScholarPubMed
Marks, I. M. (1978). Living with Fear: Understanding and Coping with Anxiety. McGraw-Hill, New York.Google Scholar
Marks, I. M., Hallam, R. S., Connolly, J. and Philpott, R. (1977). Nursing in Behavioural Psychotherapy. Royal College of Nursing, London.Google Scholar
Marshall, W. L. (1985). The effects of variable exposure in flooding therapy. Behavior Therapy, 16, 117135.CrossRefGoogle Scholar
Marshall, W. L., Gauthier, J. and Gordon, A. (1979). The current status of flooding therapy. In Progress in Behavior Modification, Volume 7. Hersen, M., Eislen, R. M. and Miller, P. M. (Eds). New York: Academic Press.Google Scholar
Mathews, A., Teasdale, J., Munby, M., Johnston, D. and Shaw, P. (1977). A home-based treatment program for agoraphobia. Behavior Therapy, 8, 915924.Google Scholar
McCutcheon, M. A. and Adams, H. E. (1975). The physiological basis of implosive therapy. Behaviour Research and Therapy, 13, 93100.CrossRefGoogle ScholarPubMed
Meyer, V. (1957). The treatment of two phobic patients on the basis of learning principles. Journal of Abnormal and Social Psychology, 55, 261266.CrossRefGoogle ScholarPubMed
Meyer, V. (1985). Lecture on biofeedback and anxiety management techniques. Middlesex Hospital Medical School, London, England.Google Scholar
Michelson, L., Mavissakalian, M. and Marchione, K. (1985). Cognitive and behavioral treatments of agoraphobia: Clinical, behavioural, and psychophysiological outcomes. Journal of Consulting and Clinical Psychology, 53, 913.CrossRefGoogle ScholarPubMed
Paul, G. L. (1966). Insight vs. Desentization in Psychotherapy. Stanford: Stanford University Press.Google Scholar
Paul, G. L. (1969). Physiological effects of relaxation training and hypnotic suggestion. Journal of Abnormal Psychology, 74, 425437.CrossRefGoogle ScholarPubMed
Rabavilas, A. D., Boulougouris, J. C. and Perissakis, C. (1979). Therapist qualities related to outcome with exposure in vivo in neurotic patients. Journal of Behavior Therapy and Experimental Psychiatry, 10, 293294.CrossRefGoogle Scholar
Rachman, S. (1983). The modification of agoraphobic avoidance behaviour—some fresh possibilities. Behaviour Research and Therapy, 21, 567574.CrossRefGoogle Scholar
Sherry, G. S. and Levine, B. A. (1980). An examination of procedural variables in flooding therapy. Behavior Therapy, 11, 148155.CrossRefGoogle Scholar
DeSilva, P. and Rachman, S. (1981). Is exposure a necessary condition for fear reduction? Behaviour Research and Therapy, 19, 227232.CrossRefGoogle Scholar
Spielberger, C. D., Gorsuch, R. L. and Luchene, R. E. (1970). State-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press.Google Scholar
Stern, R. and Marks, I. M. (1973) Brief and prolonged flooding. Archives of General Psychiatry, 28, 270276.CrossRefGoogle ScholarPubMed
Sturgis, E. T. and Scott, R. (1984). Simple phobia. In Behavioral Therories and Treatment of Anxiety. Turner, S. M., (Ed). Plenum Press, New York.Google Scholar
Telch, M. J., Agras, W. S., Taylor, C. B., Roth, W. T., and Gallen, C. G. (1985). Combined pharmacological and behavioral treatment for agoraphobia. Behaviour Research and Therapy, 23, 325335.CrossRefGoogle ScholarPubMed
Williams, S. L., and Kleifield, E. (1985). Transfer of behavioral change across phobias in multiply-phobic clients. Behavior Modification, 9, 2231.Google Scholar
Wolpe, J. (1980). The Practice of Behavior Therapy, 3rd edition. New York: Pergamon Press.Google Scholar
Wolpe, J. and Lang, P. J. (1964). A fear survey schedule for use in behavior therapy. Behaviour Research and Therapy, 2, 2730.Google Scholar
Submit a response

Comments

No Comments have been published for this article.