One-session therapist directed exposure vs two forms of manual directed self-exposure in the treatment of spider phobia.
Fifty-two patients with spider phobia, fulfilling the DSM-III-R criteria for simple phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to five different treatment conditions: (1) one session therapist-directed exposure (maximum 3 hours), (2) specific manual-based treatment in the home, (3) specific manual-based treatment at the clinic, (4) general manual-based treatment in the home and (5) general manual-based treatment at the clinic. The results show that therapist-directed one-session treatment was significantly more effective than three of the manual-based treatments, both at the post-treatment and follow-up stages. Specific manual-based treatment at the clinic was significantly more successful than the other manual-based treatments, but only at follow-up. The proportion of clinically significant improved patients at follow-up was 80% in the therapist-directed group compared to 63% for the specific manual-based treatment at the clinic, 10% for specific manual-based treatment in the home, 9% for general manual-based treatment in the home, and 10% for general manual-based treatment at the clinic. The conclusion that can be drawn is that one-session therapist-directed treatment is the treatment of choice for spider phobia but manual-based treatment is a good alternative in some cases.
D000293:Adolescent; D000328:Adult; D000818:Animals; D001143:Arousal; D003887:Desensitization, Psychologic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008370:Manuals as Topic; D008875:Middle Aged; D010698:Phobic Disorders / Q000523:psychology / Q000628:therapy*; D011380:Programmed Instructions as Topic; D011614:Psychotherapy, Brief / Q000379:methods*; D012931:Social Environment; D013112:Spiders; D016896:Treatment Outcome