The Effects of Therapist Presence and Relaxation Training on the Efficacy and Generalizability of in vivo Exposure

Abstract

The present study examined the effects of therapist presence and the addition of relaxation training on the efficacy and generalizability of in vivo exposure procedures in the treatment of multiply-phobic individuals. Thirty-two individuals who were severely phobic of at least two objects/situations were assigned to one of three treatment groups or a waiting list control group, but received treatment for only one phobia. The Exposure Alone group received prolonged exposure to a phobic stimulus while alone in a room with that stimulus. The Exposure + Relaxation group were also exposed to a phobic stimulus but had received additional training in a relaxation technique. Subjects in the Exposure + Therapist group were accompanied by a nonanxious/nonavoiding “therapist” during exposure sessions. All treatment groups improved significantly, but the Exposure + Therapist group demonstrated significantly greater extinction of fear responses related to the treated phobias than the other groups. The Exposure + Relaxation group demonstrated the greatest generalization of treatment effects to untreated phobias. Clinical and theoretical implications are discussed.