Klein D F, Zitrin C M, Woerner M G, Ross D C
Arch Gen Psychiatry. 1983 Feb;40(2):139-45. doi: 10.1001/archpsyc.1983.01790020033003.
Systematic hierarchical desensitization (behavior therapy [BT]) was compared with supportive psychotherapy (ST) during a 26-week treatment trial of patients with agoraphobia, mixed phobia, or simple phobia. We found essentially no difference in effectiveness, not because patients treated with BT had done badly, but because patients receiving ST had done well. A detailed methodologic review concludes that this finding is entirely compatible with the major critical reviews of the psychotherapy literature. Is the active ingredient in psychotherapy simply the generation of hopeful expectancies? This is necessary but not sufficient. For phobics, the psychotherapy session serves primarily as an instigator. The specific corrective activity occurs outside of the formal session in the form of maintained exposure in vivo. Supposed differences between therapies may be entirely due to the rapidly with which the instigational function becomes effective.
在一项针对广场恐惧症、混合恐惧症或单纯恐惧症患者的为期26周的治疗试验中，对系统性分级脱敏疗法（行为疗法[BT]）与支持性心理治疗（ST）进行了比较。我们发现两者在有效性上基本没有差异，这并非是因为接受行为疗法的患者疗效不佳，而是因为接受支持性心理治疗的患者表现良好。一项详细的方法学综述得出结论，这一发现与心理治疗文献的主要批判性综述完全相符。心理治疗中的有效成分仅仅是产生充满希望的期待吗？这是必要条件，但并不充分。对于恐惧症患者而言，心理治疗环节主要起到一种刺激作用。具体的矫正活动以在现实生活中持续暴露的形式发生在正式治疗环节之外。不同疗法之间所谓的差异可能完全是由于刺激功能生效的速度不同所致。
