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Cognitive Changes During In Vivo Exposure in an Agoraphobic

This case study assessed the relationship between cognitive changes and treatment outcome during in vivo exposure treatment of an agoraphobic, and at one year following the end of treatment. Results indicated that although the client was notably improved with respect to his phobic condition by the end of treatment (on all self-report, behavioral, and physiological measures), contrary to expectations, he had worsened on cognitive measures at this time. However, at one year following treatment, measures of fear and avoidance showed that relapse had occurred, while results from cognitive assessment revealed that the client's cognitions had improved. The relationship of cognitions and cognitive changes to short-term treatment outcome and the maintenance of phobic improvement over time is discussed.