Exclusive, conflict-centered treatment or integration: different mechanisms of change in panic and agoraphobia by client-centered therapy alone and in combination with behavioral exposure

The mechanisms of change due to different psychotherapeutic treatments of a nxiety disorders are the subject of the present study, Sixty-eight patients with agoraphobia and panic (DSM III R No. 300.21,ICD 10 No. F 40.01) were included, exclusively treated with client-centered treatment (n=28) or with additional behavioral exposure treatment (n=40) in an inpatient setting. T he patients were examined on admission, at discharge, and at 6 and 12 month s follow-ups with the Structured Clinical Interview for DSM III R(SKID),the Freiburg Personality Inventory (FPI R),and the Giessen Test (GIESS). Both treatment modalities significantly reduced panic and avoidance. Differences were found in personality scales. The support of autonomy was superior by client-centered treatment alone: client-centered treated (CCT) patients fel t less dependent on the expectations of others, less under stress, and had fewer psychosomatic complaints. Patients with additional exposure treatment feel accepted by their social environment earlier. The results are discuss ed with regard to open questions of therapy integration and different mecha nisms of change.