Maximizing The Effectiveness Of Exposure Therapy
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Introduction & Theoretical Background
Exposure therapy is the most effective treatment for anxiety disorders. It can take a number of forms:
- Graduated vs. intense (flooding)
- Brief vs. prolonged
- With or without cognitive or somatic coping strategies
- Imaginal vs. interoceptive vs. in vivo
There are a number of models which attempt to explain why exposure to a fear-inducing stimulus is an effective method for overcoming fear. These include:
- Habituation models which focus on the reduction of fear through exposure (e.g. Foa & Kozak, 1986)
- Cognitive models whereby behavioral testing is used to explicity disconfirm mistaken threat-laden assumptions (e.g. Salkovskis et al, 2006)
- Inhibitory learning models which propose that the original CS-US association learned during fear conditioning is not erased during extinction but is instead inhibited by new learning about the CS-US (specifically, that the CS no longer predicts the US)
Craske and colleagues (2014) propose that inhibitory learning is the most helpful
Therapist Guidance
This is a Psychology Tools information handout. Suggested uses include:
- Client handout – use it as a psychoeducation resource to teach clients how to make their exposure therapy more effective
- Discussion point – use to provoke a discussion and explore client beliefs regarding avoidance and exposure
- Therapist learning tool – improve your familiarity with an inhibitory learning theory approach to exposure therapy
- Teaching resource – use it as a learning tool when training clinicians or anxious individuals how to conduct effective exposure therapy
References And Further Reading
- Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: an inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23.
- Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: exposure to corrective information. Psychological Bulletin, 99(1), 20.
- Salkovskis, P. M., Hackmann, A., Wells, A., Gelder, M. G., & Clark, D. M. (2007). Belief disconfirmation versus habituation approaches to situational exposure in panic disorder with agoraphobia: A pilot study. Behaviour Research and Therapy, 45(5), 877-885.