Imaginal and in vivo exposure: A comparison with obsessive-compulsive checkers

Abstract

The efficacy of imaginal and in vivo exposure was compared in 19 obsessive-compulsives who manifested checking rituals. Response prevention was not instituted in either group. No difference between the two procedures was detected either at posttreatment or at follow-up; both were moderately effective in ameliorating obsessive-compulsive symptoms. There appears to be a tendency for patients treated with in vivo exposure to improve further at follow-up, whereas those treated with imaginal exposure maintained the level of gains achieved at posttreatment. In comparison with a treatment regimen which includes both exposure and response prevention, the exposure procedures in vestigated here yielded inferior outcomes. The finding of no difference between in vivo and imaginal exposure modalities is incongruent with studies on phobics. Possible explanations for this discrepancy are discussed.