Group In-Vivo Exposure Augmented by the Counselling of Significant Others in the Treatment of Agoraphobia

Jones, R. B.; Sinnott, A.; Fordham, Ann

doi:10.1017/s0141347300005966

Cited by 5 publications

(4 citation statements)

References 7 publications

(4 reference statements)

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“…As noted earlier, it appears that Barlow et al (1984) touched on communications issues in their treatment insofar as these pertained to planned exposures. Jones, Sinnott, and Scott Fordham (1980) compared group exposure for the agoraphobic patient alone with group exposure plus counseling of significant others. Spouses were not involved in treatment with the patients but were invited to separate sessions for discussion of the role of avoidance in agoraphobia and the relationship of excessive dependency and secondary gain to maintenance of phobia.…”

Section: Addressing Marital Issues In the Context Of Exposurementioning

confidence: 99%

Interpersonal aspects of panic disorder and agoraphobia.

Chambless¹

2010

Interpersonal Processes in the Anxiety Disorders: Implications for Understanding Psychopathology and Treatment.

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attack come on. This avoidance may be relatively subtle-for example, the man with panic disorder who gives up running because his rapid heartbeat makes him feel like he is panicking or having a heart attack. Or it may be highly obvious-for example, the woman who becomes afraid to leave her home unless she is accompanied by a trusted person who will take care of her should she panic. When avoidance is significant, the person is said to have panic disorder with agoraphobia, for which the lifetime prevalence is about 1% (Kessler et al., 2006). Another 1% will have agoraphobia with panic attacks but will not meet full diagnostic criteria for panic disorder (Kessler et al., 2006); for example, they will not have had recurrent unexpected panic attacks. Much of the literature cited in this chapter was written before diagnostic distinctions between agoraphobia with and without panic disorder were made, and phenomenologically there is little difference to the patient between these disorders. I use the term agoraphobia to refer to both groups. Moreover, some more recent studies have focused on panic disorder without reference to whether there is associated agoraphobia. Thus, it is not always be possible to make distinctions between panic disorder with and without agoraphobia. When possible, I do so.The social and health consequences of panic disorder are great. According to epidemiologic research, these include increased risk of alcohol and drug abuse, mood disorders, other anxiety disorders, subjectively poor health, poor social functioning, high use of health care services and emergency rooms, and financial dependence on disability and welfare payments (Kessler et al., 2006;Markowitz, Weissman, Ouellette, Lish, & Klerman, 1989). Disability is greatest for those who develop agoraphobia as a complication of panic disorder (Kessler et al., 2006). The more disabled patients become, the more likely they are to rely on family members for their daily functioning, posing a heavy burden on their intimate others. Reflecting not only agoraphobic patients' restricted lives but also the preponderance of women with the disorder-as many as 80% in clinical samples (Chambless & Mason, 1986)-an early synonym for agoraphobia was housebound housewives. Epidemiologic research has suggested that although women still predominate in the general population, the ratio of women to men with panic disorder and agoraphobia (about 2:1) is not as extreme as in clinical samples (Kessler et al., 2006).The mass of research on interpersonal aspects of agoraphobia is substantially greater and older than that for the other anxiety disorders. No doubt this is because the role of the phobic companion in agoraphobia is so striking that the interpersonal context of the disorder could not be ignored. Marks (1970) estimated that 95% of people with agoraphobia are able to venture further into phobic situations or to enter phobic situations with less anxiety if accompanied by a trusted other. In laboratory research, Carter, Hollon, Carson, and Shelton (1995) demonst...

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Section: Addressing Marital Issues In the Context Of Exposurementioning

confidence: 99%

Interpersonal aspects of panic disorder and agoraphobia.

Chambless¹

2010

Interpersonal Processes in the Anxiety Disorders: Implications for Understanding Psychopathology and Treatment.

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“…Assumptions like this have provided a rational for directing specific interventions in a couple's relationship. Involving the spouses in group treatment has been found advantageous, compared to not involving them (Jones, Sinnott & Fordham, 1980;Barlow, O´Brien & Last, 1984). In the Barlow et al study, the group that included spouses did not only perform better on measures of agoraphobia, but also on social-, work-, and family ratings.…”

Section: Involving Social Support and Significant Othersmentioning

confidence: 99%

“…The exception from this seems to be interventions not directed at individual psychopathological features, but rather at the social context of the patient by forming socially supportive groups (Hand et al, 1974;Sinnott et al, 1981) and intervening in spousal relationships (Jones, Sinnott & Fordham, 1980;Barlow et al, 1984;Arnow et al, 1985).…”

Section: Treatment Efficacymentioning

confidence: 99%

Behavioral Treatments of Panic Disorder with Agoraphobia: Treatment Process and Determinants of Change

Ramnerö¹

2005

PsycEXTRA Dataset

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The present dissertation comprises four empirical studies within the area of behavioral treatment of panic disorder with agoraphobia. The focus is on studying issues pertaining to outcome, treatment process and determinants of change. The first study is a randomized controlled treatment study of 73 patients undergoing 16 sessions of either exposure in vivo (E), or cognitive behavior therapy (CBT). Both treatments showed clear improvements at post-treatment that were well maintained at 1-year follow up, and there were no significant differences between the treatments. The second study concerned prediction of outcome in the same sample. From a variety of pre-treatment characteristics severity of avoidance was the one most related to outcome. Most predictors were found unrelated. Two approaches of prediction were also compared: treating outcome as a categorical vs. continuous variable. The different approaches yielded a somewhat dissimilar picture of the impact of pre-treatment severity of avoidance. The third study examined different aspects of the therapeutic relationship, and their relation to outcome. Clients' perceptions of therapists and their ratings of the working alliance were generally not related to outcome at any point. On the other hand, therapists' perceptions of patients as showing goal-direction and active participation were related to outcome from early on in therapy. The fourth study examined different aspects of change. It was found that change in indices of the frequency of panic attacks was not closely related to change in agoraphobic avoidance at post-treatment. Change in avoidance was also more related to other aspects of outcome. At one-year follow-up, a more unitary picture, regarding the different aspects of change was observed.

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“…Agoraphobic patients were allocated randomly to three groups which received 10 weeks of group in vivo exposure treatment. Graded practice sessions were determined by a common hierarchy developed separately and reported elsewhere (Jones et al, 1980). No significant differences existed between the three groups concerning age, symptom duration, psychiatric history and current medication.…”

Section: Designmentioning

confidence: 99%

Prediction of Outcome in the Treatment of Agoraphobia

Thomas-Peter¹,

Jones

Sinnott

et al. 1983

Behav. Cogn. Psychother.

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Seventeen female agoraphobic patients were treated in three groups by in vivo exposure over 10 sessions. Dependent measures comprised an assessment using a behavioural hierarchy and an assessment of subjective anxiety. Pre-treatment assessment of the number of problems and fears, interpersonal variables and personality as measured by the E.P.P.S. were also carried out. Correlational evidence was sought of relationships between pre-treatment assessment variables and treatment outcome. It was found that low scores for “Aggression” on the E.P.P.S. and the rated ability of designated significant others to manage the agoraphobics' behaviour successfully were predictive of good outcome. Possible reasons for and implications of these findings are discussed.

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Group In-Vivo Exposure Augmented by the Counselling of Significant Others in the Treatment of Agoraphobia

Cited by 5 publications

References 7 publications

Interpersonal aspects of panic disorder and agoraphobia.

Interpersonal aspects of panic disorder and agoraphobia.

Behavioral Treatments of Panic Disorder with Agoraphobia: Treatment Process and Determinants of Change

Prediction of Outcome in the Treatment of Agoraphobia

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