Timing of treatment and return of fear: Effects of massed, uniform-, and expanding-spaced exposure schedules

Although exposure treatment has been shown to be highly effective in ameliorating phobias, the return of fear (ROF) is often evidenced (see Rachman, 1989). The present study compared the effects of massed (single session), uniform-spaced (5,5, 5 intervening days), and expanding-spaced (1, 4, 10 intervening days) schedules on fear reduction and ROF in an analog sample with self-reported public-speaking anxiety. Treatment utilized st standardized speech exposure task. It was predicted that although massed treatment would produce the greatest fear reduction by posttreatment, it would yield the greatest ROF at I-month follow-up. The uniform schedule was expected to produce intermediate fear reduction by posttreatment and at followup, whereas the expanding schedule was predicted to generate the lowest fear reduction by posttreatment, but the least ROF at follow-up. All groups unexpectedly demonstrated comparable fear reduction by posttreatment, but, as predicted, massed treatment produced the greatest ROF at follow-up-fear ratings in this group no longer differed from pretreatment levels. Expanding and uniform treatments showed an impressive lack of ROF at follow-up; possible explanations for the unexpectedly robust performance of the uniform group are discussed. Given the high rates of attrition for the uniform schedule (50%), results provide preliminary support for the utility of an expanding schedule. Limitations of the present study, and theoretical and practical issues regarding spacing of treatment, are discussed.