Severe Agoraphobia: A Controlled Prospective Trial of Behaviour Therapy

Abstract

Severe agoraphobia is difficult to treat. Encouraging immediate results have been reported with diverse treatments, including intensive psychotherapy (Friedman, 1959), acetyl choline injections (Sim, 1964), antidepressant drugs (King, 1962) and more recently with behaviour therapy (Wolpe, 1958). It is this latter claim which this paper examines. Early reports (e.g. Meyer, 1957; Wolpe, 1958) suggested that behaviour therapy might prove to be a rapid and effective treatment, but a small series studied by Meyer and Gelder (1963) demonstrated that results were not always as effective as single case reports suggested, and showed clearly that the treatment was often lengthy, taking 80 hours on the average. A retrospective investigation of a larger series (Marks and Gelder, 1965; Cooper, Gelder and Marks, 1965) again failed to support the early claims, although it was shown that behaviour therapy is an effective treatment for circumscribed phobias such as fears of animals and insects.