The credibility of exposure therapy: Does the theoretical rationale matter?. (September 2015)

• Record Type: Journal Article
• Authors: Arch, Joanna J.; Twohig, Michael P.; Deacon, Brett J.; Landy, Lauren N.; Bluett, Ellen J.
• Is Part Of: Behaviour research and therapy. Volume 72(2015)
• Page Start: 81
• Page End: 92
• Publication Date: 2015-09
• Subjects: Exposure -- Anxiety -- Treatment -- Cognitive behavioral therapy -- Direct marketing; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2015.05.008
• Languages: English
• ISSNs: 0005-7967

Abstract

Abstract: Objective: Little is understood about how the public perceives exposure-based therapy (ET) for treating anxiety and trauma-related disorders or how ET rationales affect treatment credibility. Distinct approaches to framing ET are practiced, including those emphasized in traditional cognitive behavioral therapy, acceptance and commitment therapy, and the more recent inhibitory learning model. However, their relative effect on ET's credibility remains unknown. Method: A final sample of 964 U.S. adults provided baseline views of ET. Participants rated ET treatment credibility following a simple ET definition (pre-rationale) and following randomization to rationale modules addressing ET goals, fear, and cognitive strategies from distinct theoretical perspectives (post-rationale). Baseline ET views, symptoms, and sociodemographic characteristics were examined as putative moderators and predictors. Results: At baseline, the majority had never heard of ET. From pre- to post-rationale, ET treatment credibility significantly increased but the rationales' theoretical perspective had little impact. More negative baseline ET views, specific ethnic/racial minority group status, and lower education moderated or predicted greater increases in treatment credibility following the rationale. Conclusions: ET remains relatively unknown as a treatment for anxiety or trauma, supporting the need for direct-to-consumer marketing. Diverse theory-driven rationales similarly increased ET credibility, particularly among those less likely to use ET. Highlights: A large sample of U.S. adults provided their views of exposure therapy (ET). At baseline, more than half had no knowledge or recognition of ET. We next randomized to ET rationale modules based on ACT, CBT, and inhibitory learning. The rationale increased ET credibility, and did not differ much among themselves. Specific baseline characteristics predicted or moderated the impact of ET rationale.