Anxiety Disorders treated using exposure-based therapy
Exposure-based therapies are highly reliable for clients with anxiety problems. However, these treatments are underutilized, highlighting the demand for additional dissemination and training.
Over a quarter of the people in the United States population will have an anxiety problem at some time during their lifetime. It is well established that exposure-based behaviour therapies are effective treatments for these conditions; however, just a tiny per cent of patients are treated with exposure therapy.
For example, in the Harvard/Brown Anxiety Research Project, only 23% of treated people reported obtaining regular imaginal exposure, and also just 19% had obtained even occasional in vivo exposure.
This could partly be due to a lack of well-trained specialists, as most mental health clinicians do not obtain specialized training in exposure-based therapies. An additional aspect might be that numerous healthcare professionals do not comprehend the concepts of exposure or hold (usually unfounded) negative beliefs concerning this type of treatment.
Surveys of psychologists who treat clients with PTSD show that many do not use exposure therapy, and a lot think that exposure therapy is likely to exacerbate symptoms and signs. Nonetheless, people with trauma histories and PTSD express a preference for exposure therapy over various other treatments.
Besides, exposure therapy does not show up to cause symptom worsening or therapy discontinuation. Indeed, a wealth of evidence suggests that exposure-based treatment is related to improved symptomatic and functional outcomes for individuals with PTSD.
The available research literature suggests that exposure-based therapy needs to be considered the first-line treatment for various anxiety conditions.
References:
Becker, C. B., Darius, E., & Schaumberg, K. (2007). An analogue study of patient preferences for exposure versus alternative treatments for posttraumatic stress disorder. Behaviour Research and Therapy, 45(12), 2861-2873.
Becker, C. B., Zayfert, C., & Anderson, E. (2004). A survey of psychologists’ attitudes towards and utilization of exposure therapy for PTSD. Behaviour research and therapy, 42(3), 277-292.
Crits-Christoph, P., Frank, E., Chambless, D. L., Brody, C., & Karp, J. F. (1995). Training in empirically validated treatments: What are clinical psychology students learning?. Professional Psychology: Research and Practice, 26(5), 514.
Davison, G. C. (1998). Being bolder with the Boulder model: the challenge of education and training in empirically supported treatments. Journal of Consulting and Clinical Psychology, 66(1), 163.
Foa, E. B., Zoellner, L. A., Feeny, N. C., Hembree, E. A., & Alvarez-Conrad, J. (2002). Does imaginal exposure exacerbate PTSD symptoms?. Journal of Consulting and Clinical Psychology, 70(4), 1022.
Goisman, R. M., Rogers, M. P., Steketee, G. S., Warshaw, M. G., Cuneo, P., & Keller, M. B. (1993). Utilization of behavioral methods in a multicenter anxiety disorders study. The Journal of clinical psychiatry.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 62(6), 593-602.
Mancebo, M. C., Eisen, J. L., Pinto, A., Greenberg, B. D., Dyck, I. R., & Rasmussen, S. A. (2006). The Brown Longitudinal Obsessive Compulsive Study: treatments received and patient impressions of improvement. The Journal of clinical psychiatry, 67(11), 1713-1720.
Torres, A. R., Prince, M. J., Bebbington, P. E., Bhugra, D. K., Brugha, T. S., Farrell, M., … & Singleton, N. (2007). Treatment seeking by individuals with obsessive-compulsive disorder from the British Psychiatric Morbidity Survey of 2000. Psychiatric Services, 58(7), 977-982.
van Minnen, A., Hendriks, L., & Olff, M. (2010). When do trauma experts choose exposure therapy for PTSD patients? A controlled study of therapist and patient factors. Behaviour research and therapy, 48(4), 312-320.
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