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KMID : 0376719820060030065
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Seoul Journal of Psychiatry
1982 Volume.6 No. 3 p.65 ~ p.73
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In vivo Exposure Treatment of Agoraphobic Disorder and Necessary Therapeutic Ingredients
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Abstract
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Agoraphobic disorder has been shown to respond favorably to various behavioral techniques. Currently many methods claimed to be effective and superior to others. Several controlled studies, however, have found in vivo exposure method to be superior to in vitro imagining methods. ´Flooding" has been emphasized as the most important therapeutic factor in this direct exposure approach. Three separate treatment programs for Agoraphobic patients had been completed in three different municipalities in Union County. The program adapted Graded in vivo Exposure Method. It is consisted of fifteen group sessions. The first three sessions were exclusively educational to explore the details of the patients phobic processes. Maladaptive elements of phobic processes were analized in these sessions. The patients were also assigned to make a list of graded hierarchies of their fear provoking phobic situtions. In following seven sessions, the patients went out to expose themselves to their phobic situations starting from the lowest graded hierarchy. The therapists have actively participated to help patients to overcome various resistances. After the exposure practices, the groups met for discussions. The group dynamics and mutual support promoted strong cohesive force as small successes prevail. The patients attitudes changed as their self-esteem improved. Cognitive distancing of maladaptive thoughts occurred rather spontaneously. Alter fifteen weeks, significant improvements have been reported by patients. The patients also volunteered to meet on their own after the fifteen sessions on once a week basis. Such alumni group meeting was encouraged and assisted by the Association. Alumni meetings enhanced the understanding of the concept. To continue the exposure practice, and not to fall into avoiding pattern, was found to be very important to sustain . the level of progress each member made in the fifteen week sessions. Various therapeutic ingredients of this method are discussed in this presentation.
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