Fourteen studies were included in the review (n= 644); 11 between group study designs and three single-case series. One study met all the quality criteria for the exposure conditions. Four studies met all quality criteria for the behavioural experiment conditions. Only one study met all of the criteria for both the exposure and the behavioural experiment conditions.
Obsessive compulsive disorder (one case series, n=8): Meta-cognitive rationale was found to improve subjective ratings of anxiety, belief and urge to neutralise in a clinical sample who met diagnostic criteria for obsessive compulsive disorder. No difference was found in overall usefulness of the intervention.
Panic (three between-group studies, n=109): One good-quality study found that framing exposure as a cognitive test improved outcome relative to exposure alone on a clinical sample. No significant difference was found in the other two studies.
Social phobia (six between-group studies, two single-case series, n=428): Safety behaviour and attention manipulation studies found that behavioural experiment conditions were more effective than exposure-alone; in all cases the duration of exposure was brief. All studies except one used an analogue sample.
Specific phobia (two between-group studies, n=99): Limited evidence was found that favoured behavioural experiments in a student sample with claustrophobia fears.