M Burke1, L M Drummond, D W Johnston. 1. Department of Psychology, St George's Hospital Medical School, University of London, UK.
Abstract
OBJECTIVES: The paper describes a treatment trial where exposure was compared with cognitive-behaviour therapy in the treatment of 39 female participants with a diagnosis of agoraphobia (DSM-111-R). The primary objective of the study was to see if cognitive therapy enhanced the effectiveness of exposure in the treatment of agoraphobia. DESIGN: Participants were randomly assigned to either exposure or cognitive-behaviour therapy. The two treatment groups were balanced for severity and duration of agoraphobia, presence of panic disorder, and age. METHODS: The exposure and the cognitive-behaviour therapy groups received the same amount of therapist-assisted exposure to feared situations but the participants in the cognitive-behaviour therapy group were, additionally, taught to identify and challenge negative automatic thoughts and dysfunctional assumptions. In the cognitive-behaviour therapy condition exposure was presented as an opportunity to identify and challenge negative thoughts. In the exposure condition, participants were given a behavioural rationale for doing exposure. Participants were seen individually for 10 sessions. Assessments were carried out before and after the treatment programme and, also, six months later. Assessments included self-reports of fear and avoidance, a behavioural test and questionnaire measures of relevant cognitions. Thirteen participants dropped out of treatment leaving 14 in the exposure condition and 12 in the cognitive-behaviour condition. Therapy sessions were taped and a sample of tapes was given to a judge who rated the quality of the cognitive-behaviour therapy. RESULTS: Substantial improvement was seen on virtually all measures irrespective of treatment condition both at the end of treatment and six months later. The cognitive-behaviour therapy group and the exposure group did not differ significantly at post-treatment or at six-month follow-up.
RCT Entities:
OBJECTIVES: The paper describes a treatment trial where exposure was compared with cognitive-behaviour therapy in the treatment of 39 female participants with a diagnosis of agoraphobia (DSM-111-R). The primary objective of the study was to see if cognitive therapy enhanced the effectiveness of exposure in the treatment of agoraphobia. DESIGN:Participants were randomly assigned to either exposure or cognitive-behaviour therapy. The two treatment groups were balanced for severity and duration of agoraphobia, presence of panic disorder, and age. METHODS: The exposure and the cognitive-behaviour therapy groups received the same amount of therapist-assisted exposure to feared situations but the participants in the cognitive-behaviour therapy group were, additionally, taught to identify and challenge negative automatic thoughts and dysfunctional assumptions. In the cognitive-behaviour therapy condition exposure was presented as an opportunity to identify and challenge negative thoughts. In the exposure condition, participants were given a behavioural rationale for doing exposure. Participants were seen individually for 10 sessions. Assessments were carried out before and after the treatment programme and, also, six months later. Assessments included self-reports of fear and avoidance, a behavioural test and questionnaire measures of relevant cognitions. Thirteen participants dropped out of treatment leaving 14 in the exposure condition and 12 in the cognitive-behaviour condition. Therapy sessions were taped and a sample of tapes was given to a judge who rated the quality of the cognitive-behaviour therapy. RESULTS: Substantial improvement was seen on virtually all measures irrespective of treatment condition both at the end of treatment and six months later. The cognitive-behaviour therapy group and the exposure group did not differ significantly at post-treatment or at six-month follow-up.