Department of Psychiatry, Pusan National University College of Medicine, Pusan, Korea
Department of Psychiatry, Imperial College School of Medicine, London
Imperial College School of Medicine and King's College London
Siriraj Hospital, Bangkok, Thailand
Institute of Psychiatry, King's College London
Universidad de Chile, Santiago, Chile
Baghdad, Iraq
Correspondence: Professor Isaac M. Marks, Department of Psychiatry, Imperial College School of Medicine, Stress Self-Help Clinic, 303 North End Road, London WI4 9NS, UK. Tel: 0207 610 2594; fax: 0207 385 7471; e-mail: I.Marks{at}ic.ac.uk
Background Long-term follow-up has rarely been reported after self-exposure therapy for phobias.
Aims Completion of such a follow-up.
Method Two-year follow-up was achieved in 68 (85%) of 80 patients with phobias who had completed a previous 14-week randomised controlled trial comparing therapist-accompanied self-exposure, self-exposure or self-relaxation. Measures were self-reported ratings of symptoms, satisfaction and use of other treatment.
Results Improvement at week 14 was maintained 2 years later. Clinician-accompanied exposure and self-exposure did not differ on any measure. Compliance with self-exposure homework during weeks 0-8 predicted more improvement 2 years later. Patients who failed to improve with relaxation by week 14 improved after subsequent crossover to exposure. A need for more treatment for their phobias was still felt by 33 patients (49%).
Conclusions Patients with phobias maintained their improvement to 2-year follow-up after the end of self-exposure therapy.