The role of self-directed in vivo exposure in cognitive, behavioral, and psychophysiological treatments of agoraphobia**

The role of self-directed in vivo exposure practice in cognitive, behavioral, and psychophysiological treatments of agoraphobia was investigated. Thirty-nine severe and chronic agoraphobics (DSM-III) were randomly assigned to either Paradoxical Intention, Graduated Exposure, or Progressive Deep-Muscle Relaxation Training. Treatment consisted of 12 two-hour sessions weekly with all subjects receiving programmed-practice exposure instructions as a concomitant strategy to their primary treatment. Systematic behavioral diary recordings of all selfdirected exposure practice, in vivo anxiety, duration and accompaniment were analyzed across and within treatments. Differential temporal patterns of selfdirected exposure were revealed across treatments. Moreover, multiple linear regressions of self-directed exposure practice and in vivo anxiety levels during treatment were significantly associated with endstate functioning at posttreatment. These and related findings are discussed in terms of conceptual and clinical dimensions of habituation processes and agoraphobia treatment.