Effectiveness of Therapist-Guided Exposure and Programmed Self-Exposure in the Outpatient Treatment of Panic Disorder With Agoraphobia

Background: Exposure is highly effective for panic disorder with agoraphobia (PD/AG). However, the role of different means of delivery of exposure (therapist-guided exposure and programmed self-exposure) still needs further clarification. Objective: We examined the frequency and effectiveness of therapist-guided exposure and programmed self-exposure in cognitive behavioral therapy for PD/AG in a university outpatient clinic. Method: Anxiety symptoms were assessed in a sample of N = 93 consecutive patients with PD/AG before and after treatment, depending on the means of delivery of exposure. We measured the effects of the different means of delivery both for exposure in vivo and for interoceptive exposure (IE). Results: A combination of therapist-guided exposure and programmed self-exposure tends to result in a better outcome. This effect was shown both for exposure in vivo and for IE. Conclusion: Therapist-guided exposure and self-exposure (exposure as a homework assignment) should be applied in combination if possible.