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Effects of covert practice of modeling and of assertiveness on group flooding in vivo in the treatment of agoraphobia Leader, Leslie G.


This study investigated whether the addition of covert modeling with an assertive model (CM) and of covert assertiveness (CA) would augment the effects of prolonged group exposure in vivo in the treatment of agoraphobia. Thirty-two agoraphobic subjects were divided into three groups. One group (FL/A) received exposure augmented with CM and CA; the second group (FL) received similar exposure with placebo imagery; and the third group served as waiting-list controls. Therapy was brief, time-limited, and intensive. Each group of about five members met for three sessions evenly spaced over five days with each five-hour session including about 2-1/2 hours of in vivo exposure. Both treatment groups were encouraged to use self-paced, home-based exposure practice. Subjective self-report measures, a behavioural diary, and assessment of social performance by a significant other were used to evaluate outcome. A one month follow-up was done. Both treated groups made significant gains compared to controls at posttreatment and at follow-up. Subjective measures of anxiety and avoidance showed stronger effects than behavioural results. Marginal differences were found between treated groups with the FL/A group improving on the FL group with more total time spent away from home (and in particular when unaccompanied), and with decreased anxiety during exposure sessions. Group exposure in vivo is recommended as an efficient and effective therapy for agoraphobia.

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