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Why is exposure therapy the best treatment for anxiety? 

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Why is exposure therapy the best treatment for anxiety? 

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Exposure Therapy for Anxiety: Principles and Practice, 2nd Edition. ProtoView. 2019;2019(29).

Link: https://books.google.com/books?hl=en&lr=&id=YZ-BDwAAQBAJ&oi=fnd&pg=PP1&ots=BE4WMEIqKA&sig=pBwrIlqDipAe2trDTAZoCJjFU6c#v=onepage&q&f=false

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Source:

Meyer JM, Farrell NR, Kemp JJ, Blakey SM, Deacon BJ. Why do clinicians exclude anxious clients from exposure therapy?

Behaviour research and therapy. 2014;54(1):49-53. doi:10.1016/j.brat.2014.01.004

Link:

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Why do clinicians exclude anxious clients from exposure therapy? - PubMed

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Despite research demonstrating the effectiveness of exposure therapy for pathological anxiety, this treatment is underutilized by clinicians. Anecdotal evidence and clinical experience suggest that therapists who possess reservations about exposure therapy tend to exclude clients from this treatment…

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NHS. “How it works - Cognitive behavioural therapy (CBT).” NHS, 10 November 2022, https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/how-it-works/. Accessed 12 November 2023.

Link: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/how-it-works/#:~:text=Exposure%20therapy%20is%20a%20form,structured%20way%20through%20exposure%20therapy.

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“It is thought that learning of one form or another takes place when a person repeatedly confronts a feared stimulus (a dog) in the absence of the expected fear consequence ( the dog doesn’t bite)” (Abramowitz 5).

Each patient's exposure exercise ends when their expectations about the stimulus's danger or intolerability are completely disproved. An explanation of maladaptive attitudes about feeling anxious and how exposure treatment takes that into account comes next.

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According to Dr. Meyer et al. Therapists with higher anxiety sensitivity more often excluded clients. Therapists with more negative beliefs about exposure more often excluded clients. Exclusion of clients from exposure therapy reflects therapists' anxious concerns.

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Effective → An efficient exposure strategy consists of a well-thought-out hierarchy of triggers or circumstances that cause anxiety. Since exposure to anxiety-inducing circumstances progresses from less to more, the hierarchy is customized to each client's specific anxieties.

Ineffective → The effectiveness of the exposure strategy may be compromised if it is overly general or not customized to the client's unique anxieties. A poorly designed or unduly strict hierarchy could impede advancement.

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Effective → Exposure should take the form of a steady increase in difficulty from less anxiety-inducing to more difficult circumstances so that the client can gradually gain tolerance and confidence.

Ineffective →  It may be less successful and may even cause avoidance if the therapist exposes the client too abruptly or places them in really anxiety-inducing settings too soon

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This is followed by an explanation of maladaptive beliefs about experiencing anxiety, and how that factors into exposure treatment. Providing the example of, “patients who present with fears of amusement park rides, cowds [..] are often concerned that their arousal-related body sensations will lead to a heart attack, loss of consciousness [..]” (Abramowitz 39).

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his investigation described a connection; “Greater likelihood of excluding clients from exposure was associated with higher therapist anxiety sensitivity and endorsement of negative beliefs about exposure therapy.”(Meyer et al.). Suggesting that the more sensitivity and negative bias a therapist has towards anxiety, the more likely they are to exclude clients from exposure.