Exposure therapy
Exposure therapy is a technique in behavior therapy intended to treat anxiety disorders and involves the exposure to the feared object or context without any danger in order to overcome their anxiety.[1][2] Procedurally it is similar to the fear extinction paradigm in rodent work.[3][4] Numerous studies have demonstrated its effectiveness in the treatment of anxiety disorders such as PTSD and specific phobias.[5]
Exposure-based therapy may be effective in preventing the progression from acute stress disorder to post-traumatic stress disorder, according to a report in the June 2008 issue of Archives of General Psychiatry.[6]
It is also very closely related to exposure and response prevention, a method widely used for the treatment of obsessive–compulsive disorder.
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[edit] Techniques
Exposure therapy is based on the principles of respondent conditioning often termed Pavlovian extinction.[7] The exposure therapist identifies the cognitions, emotions and physiological arousal that accompany a fear-inducing stimulus, and attempts to break the pattern of escape that strengthens the fear response, through measured exposure to progressively stronger stimuli until habituation is reached.[8] The technique involves the creation of a program of steadily escalating steps or challenges (a hierarchy), which can be explicit ("static") or implicit ("dynamic" - see Method of Factors), that work towards a final goal representing a "non-phobic" response. The patient then voluntarily moves through the steps, with a means of terminating each step which is under voluntary control.
While therapeutic exposure has a strong evidence base, many clinicians are uncomfortable performing the technique because they do not understand it or are not confident in their own ability to utilize it.[9][10] This has prevented many who could benefit from this form of therapy from receiving it.
Exposure and flooding differ in that flooding starts at the most extreme item in a fear hierarchy, while exposure does not.[11][12]
[edit] Organizations
Exposure therapy is a behavior therapy technique. Many organizations exist for behavior therapists around the world. The World Association for Behavior Analysis offers a certification in behavior therapy [1]. This certification allows for the demonstration of knowledge regarding exposure therapy.
[edit] See also
[edit] References
- ^ Myers and Davis 2007 pp. 141–2
- ^ Joseph, J.S. & Gray, M.J. (2008). Exposure Therapy for Posttraumatic Stress Disorder. Journal of Behavior Analysis of Offender and Victim: Treatment and Prevention, 1(4), 69–80 BAO
- ^ Marks, I. (1979). "Exposure therapy for phobias and obsessive-compulsive disorders". Hosp Pract 14 (2): 101–8. PMID 34562.
- ^ Myers & Davis (2007) Mechanisms of Fear Extinction. Molecular Psychiatry, 12, 120–50.
- ^ Huppert & Roth: (2003) Treating Obsessive–Compulsive Disorder with Exposure and Response Prevention. The Behavior Analyst Today, 4(1), 66–70 BAO
- ^ Newswise: Exposure Therapy May Help Prevent Post-Traumatic Stress Disorder
- ^ Marks, Isaac Meyer (1981). Cure and care of neuroses: theory and practice of behavioral psychotherapy. New York: Wiley. ISBN 0-471-08808-0.
- ^ De Silva, P.; Rachman, S. (1981). "Is exposure a necessary condition for fear-reduction?". Behav Res Ther 19 (3): 227–32. doi:10.1016/0005-7967(81)90006-1. PMID 6117277.
- ^ C. Becker, C. Zayfert, E. Anderson. "A Survey of Psychologists' Attitudes Towards and Utilization of Exposure Therapy for PTSD". Digital Commons @ Trinity. http://digitalcommons.trinity.edu/psych_faculty/7/. Retrieved 13 June 2011.
- ^ Jaeger, J.A.; Echiverri, A.; Zoellner, L.A.; Post L. & Feeny, N.C. (2009). Factors Associated with Choice of Exposure Therapy for PTSD. International Journal of Behavioral Consultation and Therapy, 5(2), 294–310. BAO
- ^ de Silva, P.; Rachman, S. (1983). "Exposure and fear-reduction". Behav Res Ther 21 (2): 151–2. doi:10.1016/0005-7967(83)90160-2. PMID 6838470.
- ^ Cobb, J. (1983). "Behaviour therapy in phobic and obsessional disorders". Psychiatr Dev 1 (4): 351–65. PMID 6144099.
