Expectations of improvement and attitudes to treatment processes in relation to outcome with four treatment methods for phobic disorders.

One hundred and three agora- or sociophobic women who were not suitable for insight-oriented psychotherapy filled in an inventory with questions pertaining to expectations as to improvement, and attitudes towards goal of treatment and function of the therapist. The patients received one of four randomly assigned types of outpatient treatment for 3 months. All patients received basal therapy in the form of medication, standardized information and self-exposure instructions. One group received this treatment only once a month (B). The others received in addition either therapist-directed prolonged exposure in vivo (PE), dynamically oriented supportive therapy (ST), or relaxation therapy (R). The patients were rated by an independent rater with regard to symptoms and functions at the start and termination of the treatment, and at the end of the follow-up period 9 months after termination. 1) The patient's expectation as to improvement was positively associated with outcome with R and B, but there was no association with PE and ST. Thus, expectancy was associated with outcome when the treatment given was fairly unspecific. 2) A good match between the patient's pretreatment attitude to the goal of treatment and how the therapist should function was associated with a better outcome.