<P> Systematic desensitization can provide lasting relief to the majority of patients with panic disorder and agoraphobia . The disappearance of residual and subclinical agoraphobic avoidance, and not simply of panic attacks, should be the aim of exposure therapy . Similarly, systematic desensitization may also be used . Many patients can deal with exposure easier if they are in the company of a friend on whom they can rely . Patients must remain in the situation until anxiety has abated because if they leave the situation, the phobic response will not decrease and it may even rise . </P> <P> A related exposure treatment is in vivo exposure, a Cognitive Behavioral Therapy method, that gradually exposes patients to the feared situations or objects . This treatment was largely effective with an effect size from d = 0.78 to d = 1.34, and these effects were shown to increase over time, proving that the treatment had long term efficacy (up to 12 months after treatment). </P> <P> Psychological interventions in combination with pharmaceutical treatments were overall more effective than treatments simply involving either CBT or pharmaceuticals . Further research showed there was no significant effect between using group CBT versus individual CBT . </P> <P> Cognitive restructuring has also proved useful in treating agoraphobia . This treatment involves coaching a participant through a dianoetic discussion, with the intent of replacing irrational, counterproductive beliefs with more factual and beneficial ones . </P>

Irrational fear of leaving home or another safe place