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Reducing demands on clinicians by offering computer-aided self-help for phobia/panic: Feasibility study

  • Mark Kenwright (a1), Sheena Liness (a2) and Isaac Marks (a3)
Abstract
Background

Many patients with phobia/panic find it hard to access effective treatment.

Aims

To test the feasibility of computer-guided exposure therapy for phobia/panic.

Method

Self-referrals were screened for 20 min and, if suitable, had six sessions of computer-guided self-help (from a system called Fear Fighter). Pre— and post-treatment ratings of 54 patients were compared with those of 31 similar out-patients with phobia/panic who received the same treatment guided by a clinician.

Results

At pre-treatment, computer-guided cases were slightly less severe than clinician-guided patients. In a post-treatment intent-to-treat analysis, both groups improved comparably but computer-guided patients spent 86% less time with a clinician than did purely clinician-guided patients, who had no access to the computer system.

Conclusions

Computer-guided self-exposure therapy appeared feasible and effective for self-referrals and saved much clinician time. A controlled study is now needed.

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Copyright
Corresponding author
Mark Kenwright, NHS Stress Self-Help Clinic, 303 North End Road, London W114 9NS. e-mail: m.kenwright@hotmail.com
Footnotes
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Declaration of interest

One of the authors (I. M.) shares intellectual property rights in the computer-guided system.

Footnotes
References
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Bebbington, P. E., Brugha, T. S., Farrell, M., et al (2000) Unequal access and unmet need: neurotic disorders and the use of primary care services. Psychological Medicine, 30, 13591367.
Coulter, A. (1995) Shifting the balance from secondary to primary care. British Medical Journal, 311, 14471448.
Department of Health (2000) The NHS Plan. London: Department of Health.
Leon, A. C., Portera, L. & Weissman, M. M. (1995) The social costs of anxiety disorders. British Journal of Psychiatry, 166 (suppl. 27), 1922.
Marks, I. M. (1986) Behavioural Psychotherapy. Bristol: John Wright.
Marks, I. M. (1999) Computer aids to mental health care. Canadian Journal of Psychiatry, 44, 548555.
Marks, I. M. & Mathews, A. M. (1979) Brief standard self-rating for phobic patients. Behaviour Research and Therapy, 17, 263267.
McDonough, M. & Marks, I. M. (2001) Teaching medical students exposure therapy: a randomised comparison of face-to-face vs computer instruction. Medical Education, in press.
Shaw, S. C., Marks, I. M. & Toole, S. (1999) Lessons from pilot tests of computer self help for agora/claustrophobia and panic. MD Computing, 16, 4448.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Reducing demands on clinicians by offering computer-aided self-help for phobia/panic: Feasibility study

  • Mark Kenwright (a1), Sheena Liness (a2) and Isaac Marks (a3)
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