{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:30:09Z","timestamp":1784673009136,"version":"3.55.0"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2004,1,14]],"date-time":"2004-01-14T00:00:00Z","timestamp":1074038400000},"content-version":"unspecified","delay-in-days":13,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2004,1]]},"abstract":"<jats:p><jats:bold>Background.<\/jats:bold> The demand for time-consuming psychotherapy of phobia\/panic exceeds the supply of trained therapists. Delegating routine therapy aspects to a computer might ease this problem.<\/jats:p><jats:p><jats:bold>Method.<\/jats:bold> Ninety-three out-patients with phobia or panic disorder were randomized in a 2[ratio   ]2[ratio   ]1 ratio to have self-exposure therapy guided either mainly by a stand-alone computer system (<jats:italic>FearFighter<\/jats:italic>) or entirely face-to-face by a clinician, or to have mainly computer-guided self-relaxation as a placebo. Both computer groups (<jats:italic>FearFighter<\/jats:italic> and relaxation) had brief back-up advice from a clinician. Primary outcome measures were self- and blind-assessor ratings of Main Problem and Goals, and Global Phobia.<\/jats:p><jats:p><jats:bold>Results.<\/jats:bold> Drop-outs occurred significantly more often in the two self-exposure groups (43% if mainly computer-guided, 24% if entirely clinician-guided) than with self-relaxation (6%); the difference between the two self-exposure groups was not significant. Even with all drop-outs included, the mainly computer-guided exposure group and the relaxation group had 73% less clinician time per patient than did the entirely clinician-guided exposure group. The two self-exposure groups had comparable improvement and satisfaction at post-treatment and at 1-month follow-up, while relaxation was ineffective. Mean improvement on the primary outcome measures (self- and assessor-rated) was 46% computer, 49% clinician, 9% relaxation at post-treatment (week 10) and 58% computer, 53% clinician and \u22124% relaxation at 1-month follow-up (week 14). Mean effect sizes on the primary outcome measures were 2\u00b79 computer, 3\u00b75 clinician and 0\u00b75 relaxation at post-treatment; and 3\u00b77 computer, 3\u00b75 clinician and 0\u00b75 relaxation at 1-month follow-up. The assessor did not rate patients at follow-up.<\/jats:p><jats:p><jats:bold>Conclusions.<\/jats:bold> Despite its (non-significantly) higher dropout rate, self-exposure therapy for panic\/phobia cut clinician time per patient by 73% without losing efficacy when guided mainly by a computer rather than entirely by a clinician. The finding needs confirmation at a follow-up that is longer and includes a blind assessor. Self-relaxation had the highest rate of completers but was ineffective.<\/jats:p>","DOI":"10.1017\/s003329170300878x","type":"journal-article","created":{"date-parts":[[2004,1,14]],"date-time":"2004-01-14T06:11:50Z","timestamp":1074060710000},"page":"9-17","source":"Crossref","is-referenced-by-count":182,"title":["Saving clinicians' time by delegating routine aspects of therapy to a computer: a randomized controlled trial in phobia\/panic disorder"],"prefix":"10.1017","volume":"34","author":[{"given":"I. M.","family":"MARKS","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"KENWRIGHT","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"McDONOUGH","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"WHITTAKER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"MATAIX-COLS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2004,1,14]]},"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S003329170300878X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T19:02:43Z","timestamp":1554490963000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S003329170300878X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,1]]},"references-count":0,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2004,1]]}},"alternative-id":["S003329170300878X"],"URL":"https:\/\/doi.org\/10.1017\/s003329170300878x","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,1]]}}}