Recasting Psychodynamics into a Behavioral Framework: A Review of the Theory of Psychopathology, Treatment Efficacy, and Process of Change of the Affect Phobia Model

The objective of this article is to review empirical evidence on the theory of psychopathology, treatment efficacy, and proposed process of change of the affect phobia model, a form of short-term dynamic psychotherapy reformulated into a behavioral framework developed by Leigh McCullough. A search of the literature was conducted using Medline and PsycINFO. Eighteen empirical studies respected the inclusion criteria. The results suggest that the assessment of affect phobias has been neglected. Affect phobias’ hypothesized origins in childhood and their disorder specificity have not been investigated empirically. Randomized controlled trials showed no significant differences between affect phobia therapy and cognitive therapy at posttreatment and two-year follow-up among Cluster C personality disorders, and a greater symptom decrease in affect phobia therapy than in a controlled condition among depression and anxiety disorders. A pilot study revealed that depressed pregnant women also improved after affect phobia therapy. There is some but limited evidence that the process of change during treatment is coherent with the model’s assumptions. Research on the theory of psychopathology, treatment efficacy, and proposed process of change of the affect phobia model is in its early stage. Nevertheless, the model is promising and deserves additional research.