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Agoraphobia

People with agoraphobia fear leaving the house and traveling to public places. Typically, they are afraid that they will develop alarming symptoms such as dizziness, palpitations, and shortness of breath in these places and be unable to escape or to receive help. In any given year between 2 and 4 percent of the adults in the United States experience this fear, women twice as frequently as men. People typically develop agoraphobia in their twenties or thirties.

Treatments for Agoraphobia

Behaviorists have developed a variety of exposure approaches for agoraphobia. In these approaches, the therapists typically help clients journey farther and farther from their homes and enter outside places gradually. Sometimes they use rewards, encouragement, reasoning, and coaxing to get the clients to face the outside world.

Exposure therapy for people with agoraphobia often makes use of support groups and self-help programs. In the support group approach, a small number of people with the disorder go out together for exposure sessions, which can last for several hours. The group members support and encourage one another; eventually, they even coax one another to move away from the safety of the group and perform exposure tasks on their own. In self-help programs, individuals and their families carry out the exposure treatments themselves, often following the detailed instructions of a clinician.

Exposure treatment has had considerable success with agoraphobia. Between 60 and 80 percent of those who receive this treatment find it at least somewhat easier to enter public places, and their improvement persists for years. However, improvements are often partial rather than complete, and as many as half of the people suffer relapses. But previous gains are quickly recaptured if a person is treated again. People whose agoraphobia accompanies a panic disorder benefit less from exposure therapy alone.