Effects of four treatment methods on social phobic patients not suitable for insight-oriented psychotherapy.

Forty-two social phobic men and women, rated unsuitable for insight-oriented psychotherapy, received one of four randomly assigned types of treatment for 3 months. All patients received basal therapy (B) in the form of standardized information, self-exposure instructions, and anxiolytic medication. One group received this treatment only, with monthly appointments. The others, in addition, received either therapist-directed prolonged exposure in vivo, in some cases supplemented with exposure in imagination (PE), dynamically oriented supportive therapy (ST) or relaxation therapy (R). There was a 9 months' follow-up period. The phobia variables were more improved in the PE and ST groups than in the R and B groups at the termination of treatment. Although improvement had deteriorated somewhat in the PE group during follow-up, the improvement in target phobia was better than in the other groups. There were almost no improvements in the R and B groups. ST and PE groups also showed improved social function while the global rating showed most improvement in the PE group. The B group was not improved at all and the R group only showed a short-lived drop in muscular tension.