| The present study investigated a new procedure, termed active-imaginal exposure, that was designed to preserve the convenience of traditional imaginal exposure, but increase its effectiveness by including an in vivo coping component where the client physically performs coping responses to the imagined stimulus. Eighty-two participants meeting DSM-IV criteria for specific phobia were randomly assigned to one of three exposure treatments for dog phobia: in vivo, active-imaginal, or imaginal. Participants were given a behavioral approach test with a real dog at pre, post, and four-week follow-up. Outcome measures included subjective fear, heart rate, and behavioral approach. We evaluated mental imagery ability and use of safety behaviors as moderators, and self-efficacy as a mediator. All three treatments resulted in marked improvement at post and follow-up. The in vivo treatment was more effective than imaginal. Active-imaginal exposure did not differ significantly from imaginal or in vivo. Imagery ability did not moderate treatment. Use of safety behaviors interfered with treatment across all conditions and tended to moderate treatment. Self-efficacy did not mediate treatment. |
