ISSUES AND INNOVATIONS IN NURSING PRACTICE Agoraphobia: nurse therapist-facilitated self-help manual Karina Lovell BA MSc PhD RN Senior Lecturer in Mental Health, School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, UK Debbie Cox RMN Research Nurse, School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, UK Rachel Garvey MSc RMN Cognitive Behaviour Therapist, Cognitive Behaviour Therapy Department, East Cheshire NHS Trust, Macclesfield, UK David Raines MSc Cognitive Behaviour Therapist, Psychology Department, Stepping Hill Hospital, Stockport, UK David Richards BSc PhD RN Professor of Mental Health Nursing, School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, UK Patrick Conroy BSc RMN Cognitive Behaviour Therapist, Psychotherapy Department, Mossley Hill Hospital, Liverpool, UK and Dean Repper MSc RMN Director, National Institute for Mental Health in England, North West Regional Development Centre, Hyde, UK Received for publication 27 March 2002 Accepted for publication 30 April 2003 Correspondence: Karina Lovell, School of Nursing, Midwifery and Health Visiting, Coupland III, University of Manchester, Manchester M13 9PL, UK. E-mail: karina.lovell@man.ac.uk LOVELL K., COX D., GARVEY R., RAINES D., RICHARDS D., CONROY P. & LOVELL K., COX D., GARVEY R., RAINES D., RICHARDS D., CONROY P. & REPPER D. (2003) REPPER D. (2003) Journal of Advanced Nursing 43(6), 623–630 Agoraphobia: nurse therapist-facilitated self-help manual Background. Agoraphobia is a common and disabling mental health disorder. Substantial evidence supports the use of cognitive behaviour therapy (CBT), in particular the intervention termed exposure therapy, as the treatment of choice. However, although the evidence base for cognitive-behaviour therapy is extensive, the service delivery evidence base is poor, and alternative ways of delivering therapy are required if mental health services are to achieve standards set out by the National Service Framework in the United Kingdom. Aim. The study had two aims: (1) to develop a self-help manual, which could be facilitated by a nurse trained in CBT, for clients suffering from agoraphobia and (2) to pilot the self-help manual and evaluate its effectiveness. Method. The self-help manual was piloted with experienced nurses trained in CBT on three clinical sites for 10 weekly sessions of 30 minutes duration. A range of clinical outcome measures was administered by an independent assessor before and after treatment and at 1-month follow-up. Results. A total of 18 clients completed treatment and results showed improve- ment on all clinical measures; improvement was maintained at 1-month follow-up. Importantly, 89% of clients were clinically significantly improved at post-treat- Ó 2003 Blackwell Publishing Ltd 623