One versus five sessions of exposure in the treatment of flying phobia

Twenty-eight patients with flying phobia, fulfilling the DSM-IV criteria for specific phobia, were assessed with behavioral, and self-report measures. They were randomly assigned to two treatment conditions: (1) 1-session, or (2) 5-sessions of exposure and cognitive restructuring. The first condition consisted of a single 3 hr session of massed treatment, and the second condition of 6 hr of gradual treatment. Treatment was done individually by very experienced therapists. The results showed that the two treatment conditions did equally well and there were no differences between them. At post-treatment 93% of the 1-session group and 79% of the 5-session group managed to take an unaccompanied return fight. At the 1-yr follow-up assessment the effects were maintained on all measures except the behavioral test; in both groups 64% of the patients took the flight. The most plausible reason for this deterioration is that during the follow-up year the subjects who relapsed didn't have the opportunity to fly as a job requirement with the employer paying the expenses. The implications of these results are discussed.