Slow versus Rapid Exposure in vivo of Phobics

Publisher Website
Google Scholar
Abstract
Twenty-eight chronically phobic patients had therapist-aided exposure either rapidly or slowly. During therapist-aided exposure move to the next hierarchy item occurred after subjective anxiety had dropped, on a scale of 0–8 by two points (rapid) or by four points (slow). Exposure began with the lowest of eight hierarchy items. All patients had self-exposure homework between sessions. In a balanced design 12 patients were treated in London and 16 in Istanbul. Peak anxiety during sessions was comparable in both groups. Compared to slow exposure patients, rapid exposure patients completed treatment to criterion in fewer sessions and less time (4·7 vs. 5·8 sessions P< 0·01; 360 vs. 484 min P< 0·005). Criterion for termination of treatment was toleration of the highest hierarchy item with minimal discomfort, or a maximum of eight sessions. Both in London and in Istanbul rapid and slow groups improved substantially and similarly in phobias, social adjustment and mood; gains continued to 6 months follow-up. Compared to slower exposure, rapid exposure does not enhance final outcome but does shorten treatment time without increasing peak anxiety during sessions.