Paradoxical instruction in the elimination of avoidance behavior in an agoraphobic girl.
The case is described of a 16-yr-old girl whose agoraphobia was of recent onset. In the light of a rapidly increasing pattern of escape and avoidance behavior associated with several phobic situations, treatment consisted of a paradoxical instruction to embellish subjective anxiety and elicit anticipated negative consequences during prolonged in vivo exposure. Treatment was associated with the elimination of avoidance behavior and a dramatic reduction in self-reported anxiety, and obsessive-compulsive complaints, as well as anxiety ratings during exposure. These improvements were maintained and enhanced at both 3- and 9-month follow-up. The implications of this approach with severe fears and the need for additional empirical evaluations are discussed.
D000293:Adolescent; D000379:Agoraphobia / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000628:therapy; D010200:Panic; D010698:Phobic Disorders / Q000628:therapy*