Data from the first three years of this project have revealed that couples treatment of agoraphobia provides a significant advantage over agoraphobics treated without the involvement of their spouse. This finding confirms, in a preliminary way, that couples treatment may strengthen considerably the rather limited clinical results from existing psychological or pharmacological treatments. Preliminary data have also yielded the somewhat unexpected finding that absolute amount of exposure to feared situations is not necessarily associated with treatment success or failure, although a certain minimum amount of exposure is probably necessary. Furthermore, couples treatment may overcome, at least at post-treatment, the deleterious effect of poor marital adjustment on outcome, although the N in this group is too small to draw firm conclusions and this issue was examined only in a post hoc fashion. Preliminary data also indicate that changes in the interpersonal relationship, vis-a-vis the agoraphobia during treatment, may be critical to success and distinguish responders from non-responders. This research plan will attempt to replicate and extend these observations by examining the effects of couples treatment on groups of 20 agoraphobics each from both poorly adjusted and well adjusted marriages at post test and follow-up. Through the introduction of a number of new dependent measures, precise changes in couples' interactions surrounding the agoraphobic problem during treatment will be pinpointed to determine the relationship of these changes to short and long-term outcome. All treated agoraphobics will continue to be followed to examine the long-term impact of marital adjustment on outcome of treatment. Finally, investigation of the implications of desynchrony among response systems in predicting short and long-term outcome will continue as will a thorough analysis of possible reasons for treatment failures. In addition, a preliminary analysis of similarities and differences of male and female married agoraphobics on outcome and changes in marital adjustment will be possible since a small group of male agoraphobics will undergo couples treatment.
| Last, C G; Barlow, D H; O'Brien, G T (1985) Assessing cognitive aspects of anxiety. Stability over time and agreement between several methods. Behav Modif 9:72-93 |
| Last, C G; O'Brien, G T; Barlow, D H (1985) The relationship between cognitions and anxiety. A preliminary report. Behav Modif 9:235-41 |
