Cognitive and Guided Mastery Therapy ofAgoraphobia: Long-Term Outcome and Mechanisms ofChange
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The aims of this study were to compare thelong-term efficacy of cognitive and guided masterytherapy of panic disorder with moderate to severeagoraphobia and to analyze cognitive mechanisms ofchange. Patients (N = 46) suffering from panic disorderwith moderate or severe agoraphobia, who regardedagoraphobia as their main problem, were randomlyassigned to receive either cognitive therapy or guided mastery therapy in a 6-week inpatient groupprogram. At 1-year follow-up, more of the cognitivetherapy patients were behavioral responders, were freeof spontaneous panic attacks, were able to work, and did not use anxiolytic medication. Oncontinuous outcome measures, overall tests revealed nodifferences between the patients in the two treatmentconditions. Results of path analyses of cognitivevariables were consistent with the cognitive model ofpanic with agoraphobia which is based on catastrophicbeliefs and inconsistent with the guided mastery modelwhich is based on self-efficacy.

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