title: Relation between outcome and the patient's initial experience of the therapist and therapeutic conditions in four treatment methods for phobic disorders.
abstract: One hundred and three phobic women not suitable for insight-oriented psychotherapy were randomized to either therapist-directed prolonged exposure therapy (PE), supportive therapy of dynamic type (ST), relaxation therapy (R), or basal therapy (B). Immediately after seeing their therapist for history taking and beginning of treatment, the patients were asked to report their experience of the therapist, of themselves in relation to the therapist, and of the therapy (Experience of Therapy Inventory, ETI). The patients were informed that the therapists would not see the ETI. The patients were rated by an independent rater with regard to symptoms and functions at the beginning of treatment, at termination of treatment 3 months later, and at a follow-up 1 year after the commencement of the study. 1) Patients treated with PE and R were more satisfied with their therapists than patients treated with ST or B. The PE patients considered their therapists provided better contact, were more assured and knowledgeable, and gave what seemed to be the correct therapy, the R patients considered their therapist showed more warmth. Both PE and R patients felt their therapists were more interested than the ST and B therapists. These differences were probably due to differences in the amount of time offered, in the attitudes of the therapists, and in the characteristics of the therapies. 2) In the PE group there were positive associations between outcome and the initial experience of the therapist. There is, thus, empirical evidence that a good therapist-patient relation is of importance to a good outcome in this type of behaviour therapy. In the ST group there was an association between a good outcome and a positive experience of the rather conflict-centred beginning of the procedure. A positive experience of a conflict-centred approach may thus be regarded as an indication for dynamic therapy.
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000628:therapy; D001521:Behavior Therapy / Q000379:methods*; D003887:Desensitization, Psychologic / Q000379:methods; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D009126:Muscle Relaxation; D010698:Phobic Disorders / Q000628:therapy*; D011369:Professional-Patient Relations; D011379:Prognosis