Agoraphobia

Abstract

Agoraphobia is among the most disabling of phobias and is one of the most challenging to treat. This chapter reviews historical and modern approaches to the treatment of agoraphobia, with a generational delineation based on progressive methodological advances. It examines early, first generation treatment studies of systematic desensitization, imaginal flooding, self‐observation, guided mastery, and self‐directed exposure. It then provides an overview of second and third generation studies, which focus primarily on cognitive behavioral treatment approaches and employ the gold standard guidelines of modern, randomized controlled trials. Parameters of exposure therapy (e.g., group vs. individual), exposure augmentation strategies, innovative treatment delivery systems, alternative psychotherapies (e.g., psychodynamic and acceptance‐based therapies), and predictors of treatment outcome are also discussed. The chapter ends by presenting several high priority areas for future agoraphobia treatment research. Paramount among these is the development and evaluation of cognitive behavioral treatments for agoraphobia patients displaying significant situational avoidance in the absence of panic disorder/panic attacks.

Emotional Processing Theory Put to Test: A Meta‐Analysis on the Association Between Process and Outcome Measures in Exposure Therapy

“…It is considered to be the treatment of first choice for pathological fear and avoidance (e.g., Emmelkamp & Ehring, ). Yet, the working mechanisms of effective exposure therapy are still a subject of debate, with conditioning, learning and cognitive appraisal theories being the most prominent approaches (Telch, Cobb, & Lancaster, ). A seminal and frequently cited model to explain how exposure treatment for anxiety disorders works is emotional processing theory (EPT) put forward by Foa and Kozak ().…”