Although cognitive restructuring (CR) procedures have not proven very helpful for phobics in recent studies, insight and rehearsal components of CR have often been confounded. To seek possible differences in effectiveness between insight and rehearsal, we treated 16 phobics (eight agoraphobics and eight others) with four sessions of each method, using a counterbalanced crossover design with 1-month follow-ups after each treatment component. Significantly fewer sessions were attended by the clients in the rehearsal/insight sequence, and benefit ratings made by project completers significantly favoured insight/rehearsal. Few other treatment group differences were seen, but those that emerged gave the advantage to insight. Rehearsal seemed unhelpful, particularly to non-agoraphobics. Conclusions are (1) that CR methods show some promise in application to phobias, provided that self-exposure homework forms the core of the treatment plan, and (2) that insight followed by rehearsal is the preferred sequence.
Available at: http://works.bepress.com/gordon_kulberg/1/