Self-exposure therapy for panic disorder with agoraphobia: Randomised controlled study of external v interoceptive self-exposure

Background Exposure to external phobic cues is an effective therapy for panic/agoraphobia but the value of exposure to interoceptive cues is unclear. Aims Randomised controlled comparison in panic/agoraphobia ofthe effects of (a) external, (b) interoceptive or (c) combined external and interoceptive self-exposure to (d) control subjects. Method Eighty out-patients were randomised to a control group or to one of three forms of self-exposure treatment (external, interoceptive, or combined). Each treatment included seven sessions over 10 weeks and daily self-exposure homework. Assessments were at preand post-treatment and up to I year post-entry. Assessors remained blind during treatment. Results The three self-exposure groups improved significantly and similarly at post-treatment and up to 1-year follow-up, and significantly more than did the control subjects. Rates of improvement on main outcome measures averaged 60% at post-treatment and 77% at follow-up. Conclusions The three methods of self-exposure were equally effective in reducing panic and agoraphobic symptoms in the short- and long-term. Declaration of interest Supported by Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP).