A study targeted therapists’ resistance to use this therapy.
Exposure therapy is a key aspect of cognitive behavioral therapy (CBT), a modality inherent to eating disorders treatment (especially partial hospital, residential, and inpatient care), yet it is not universally accepted. In exposure therapy, a patient is gradually exposed to triggers to individual fears, such as fear of eating, fear of specific foods, and cues to binge eating, for example.
Two researchers recently tested the impact of teaching clinicians about using exposure therapy among patients with eating disorders, to see if this could change negative attitudes about this therapy (Int J Eat Disord. 2020; 53:107). In a sense, this non-randomized, controlled study also exposed a group of clinicians to the practice of exposure therapy.
Drs. Charlotte Wright and Glenn Waller of the University of Sheffield, Sheffield, UK, designed a study in which 47 clinicians had 90 minutes of teaching on exposure therapy within CBT. A control group of 42 clinicians also had 90 minutes of teaching CBT for patients with eating disorders. Both groups completed the Therapist Beliefs about Exposure Scale (TBES) and the Intolerance of Uncertainty Scale (IUS) at the beginning of the study. The researchers also measured the frequency of use of exposure techniques at the beginning and end of the study. Both groups of participants were closely matched in age and in time working with eating disorders patients.
Education about the technique improved attitudes towards it.
The two researchers found that simple education about the use of exposure-based models within CBT had a positive effect upon participants’ beliefs about adding exposure therapy. An earlier study by Deacon et al. (J Anxiety Disord. 2013; 27:772) found that negative beliefs about exposure therapy were associated with therapists’ demographic characteristics, negative reactions to a series of exposure therapy case vignettes, and the cautious delivery of exposure therapy in the treatment of a hypothetical client with obsessive-compulsive disorder.
The results of this study show that attitudes to exposure can be changed. More broadly, the results suggest that brief, targeted training can help to encourage the use of specific beneficial therapeutic approaches.
