Candidate: Ellen I. Koch

Degree of: Doctor of Philosophy

Department: Psychology

Title: Comparison and Generalization of Behavioral and Cognitive-Behavioral One-Session Exposure Treatments for Small Animal Phobias

Committee:
Dr. C. Richard Spates, Chair
Dr. Lester W. Wright, Jr.
Dr. Galen J. Alessi
Dr. Elaine L. Phillips

Date: Thursday, July 26, 2001, 10:00 a.m. - 12:00 p.m., 3715 Wood Hall

Abstract:
Previous studies have shown in vivo one-session exposure treatment procedures to be effective with and without the use of explicit cognitive interventions within the treatment procedures in terms of change produced on cognitive, behavioral, and self-reported measures of anxiety for thirty-eight participants randomly assigned to one of the two treatment conditions. This study also assessed the generalization effects of programmed and non-programmed generalization procedures. A three-factor repeated-measures design was used to assess the effectiveness of treatment type and generalization condition over time. Participants received treatment for snake, spider, rat, mouse, or crawling insect phobia. Along with the one treatment session, participants completed pretest, posttest, one, and three-month follow-up assessments. Both treatments produced significant improvements from pretest to posttest and these results were maintained through the three-month follow-up. No differences between the two treatment conditions existed except that participants in the behavioral treatment condition reported that the treatment was significantly more intrusive than participants in the cognitive-behavioral treatment condition. In addition, the two conditions did not differ in treatment duration. The effect sizes for both treatment conditions ranged from large to very large across behavioral, self-report, and subjective rating measures. The generalization condition did not improve results through the three-month follow-up. A significant number of participants in the behavioral treatment, generalization condition dropped out of the study prior to the one-month follow-up. An intent-to-treat analysis with dropout participants at each phase of the study produced significant effects from treatment even when these participants are included as treatment failures. Clinically significant improvements were found especially for the Behavioral Avoidance Test measures and diagnostic status. The results are discussed in terms of the overall effectiveness of one-session exposure treatments for small animal phobias as well as the relative contributions of cognitive, behavioral, and programmed generalization components of treatment.

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