Suitability for insight-oriented psychotherapy as a prognostic factor in treatment of phobic women.

Abstract

Suitability for insight-oriented psychotherapy comprises many factors that may have a positive relation to outcome in individual psychotherapy. We wanted to test the hypothesis that patients suitable for insight-oriented psychotherapy (I patients) improve more than not-suitable patients (NI patients) in non-dynamic therapies. Pairs of phobic female NI and I patients were formed with age, type of phobia, global rating of severity, therapist and type of therapy as matching variables. All women received a simple basal therapy in the form of standardized information, self-exposure instructions and anxiolytic medication. Six pairs received this treatment only, six pairs in addition received relaxation therapy and nine pairs in addition received therapist-directed prolonged exposure in vivo. The patients were rated with regard to symptoms and functions at the start of the treatment, at the termination of treatment 3 months later, and at a 1 year follow up. NI patients were less often married, had a longer duration of their phobias, and had higher initial ratings on aspects of indirect as well as direct manifestations of anxiety, ego restriction, and global severity. I patients improved more than NI patients with regard to aspects of the target phobia, both at the termination of the treatment and at the follow up. Otherwise the outcome was similar. There was no indication of a greater amount of conflict solution in the I patients. The result might be explained by supposed differences in the amount of self-exposure. The hypothesis was supported, but the results cannot be applied to other types of neuroses.