Long-Term Efficacy of Ungraded Versus Graded Massed Exposure in Agoraphobics

Abstract

At present, exposure therapy is obviously the psychological treatment of choice for agoraphobia. About two-thirds of the patients are improved at the end of treatment, about one-third even seem to be cured. Yet, long-term efficacy of exposure therapy has not been evaluated very often, and the reported effects vary more than for the short-term evaluations (e.g., Hand et al. 1974; Mathews et al. 1977; Emmelkamp and Kuipers 1979; Goldstein 1982; McPherson et al. 1980; Munby and Johnston 1980; Burns et al. 1983; Michelson et al. 1985; Fiegenbaum 1986; Hand et al. 1986). It is possible that long-term stability of beneficial therapeutic effects varies with the type of exposure used and with the coping rationale that the patients use when confronted with agoraphobic stimuli after the end of therapy. Therefore, studies are needed that evaluate the long-term effects of different types of exposure therapy and contribute to identify those variables that favor enduring benefits.