Results of Behaviour Therapy in 77 Psychiatric Patients

Abstract

Studies were made of 77 patients who received behaviour therapy in the Bethlem Royal and Maudsley Hospitals between 1956 and 1963. They were assessed and followed up for one year after treatment, together with matched control groups (55 patients). Assessment of symptoms was made blindly by two independent judges. Twenty-nine severe agoraphobics did slightly but not significantly better than their 29 controls. Twelve “ other phobics ” —for example, animals, insects, thunder—showed far more improvement than 11 controls, this difference being significant at the end of treatment, but diminished and was no longer so after one year's follow-up. Differential response to treatment paralleled different clinical features of severe agoraphobia compared with other phobias. The latter were more continuous, much more circumscribed, with fewer other disturbances. Results were poor in 13 patients with writer's cramp and 10 with obsessive rituals. Their corresponding controls also did poorly. Results were also poor in 13 patients with miscellaneous conditions. It is concluded that behaviour therapy was useful in patients with circumscribed phobias, and is worth further application in other conditions in which anxiety is manifest in relatively specific situations. The commonly reported figure of two-thirds improvement in mixed groups of neurotic patients is misleading in that it conceals marked differences in improvement rates from 0 to 100% in the course of different clinical syndromes, depending upon the timing and degree of improvement under consideration. © 1965, British Medical Journal Publishing Group. All rights reserved.