A Comparative Study Of Cognitive Restructuring And Self-Control Desensitization Techniques In The Group Treatment Of Agoraphobia

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Degree Name

Doctor of Philosophy (Ph.D.)


Purpose. Agoraphobia combines fear of anxiety or panic with avoidance behaviors. This study investigated the relative effectiveness of three different methods of treating agoraphobia in groups, cognitive restructuring, (CR), self-control desensitization (SCD), and cognitive restructuring combined with self-control desensitization (CR + SCD). A fourth group, self-help control (SHC), was composed of volunteer members from a self-help group for agoraphobics.Procedures. Treatment and self-help subjects were recruited based on specific diagnostic and screening criteria. Thirty-nine subjects completed the research program with pretest, posttest, and follow-up data collected on all subjects. Therapist's manuals delineated the procedures used and the distinguishing features of each treatment.To assess the comparative effectiveness of the treatments, six dependent variables were selected. They were: (1) frequency of panic attacks, (2) general anxiety, (3) phobic anxiety, (4) avoidance behaviors in six phobic situations, (5) interpersonal dependency, (6) subjective feelings of self-control. The study also addressed itself to the classification of agoraphobics as submissive-dependent personalities as measured by the Millon Clinical Multiaxial Inventory (MCMI).The statistical design was a one-way analysis of Covariance (ANCOVA), done with three orthogonal comparisons.Findings. The results of ANCOVA with orthogonal comparisons were essentially nonsignificant; however, F values for two of the three measures of phobic anxiety reached significance. 64.1% of the experimental subjects were classified by the MCMI as submissive-dependent personalities.Conclusions and Discussion. The following conclusions appear to be justified: (1) agoraphobics who select self-help as a means of recovery are less anxious and less avoidant than agoraphobics who select professional treatment; (2) agoraphobics who select self-help are as convinced of its potential effectiveness as are agoraphobics who select treatment; (3) a 12-week treatment program does alleviate agoraphobic symptomatology; (4) there is a significantly higher proportion of submissive-dependent personalities in the agoraphobic population than in the general population.It was recommended that future outcome studies utilize a battery of instruments which might be more sensitive to agoraphobic anxiety, (2) study the phenomenon of self-help for agoraphobia as compared with professional treatment, (3) control more effectively for pretest and outcome differences through matching and/or improved randomization, increased number of subjects, and increased length of treatment time.


Education, Educational Psychology

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