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Brett Deacon

The diagnosis and treatment of exposaphobia, or why clinicians dislike exposure therapy and what to do about It

Exposure-based CBT (exposure therapy) is the most effective treatment for anxiety-related disorders. However, clinicians often forego the use of exposure in favour of more “feel good” but less effective techniques such as cognitive restructuring, mindfulness, and anxiety-reducing coping skills. Even when therapists use exposure, it is often delivered in an unnecessarily cautious manner that compromises its benefits. Therapist concerns that exposure is unsafe, intolerable, and unethical have emerged as a critical barrier to its dissemination. Fortunately, emerging research also demonstrates that negative beliefs about exposure are modifiable through training and experience. In this presentation, I discuss research on therapist negative beliefs about exposure, the various ways they can impair the effective delivery of exposure, and the good news that clients are much less concerned about exposure than therapists. Strategies for learning to confidently and effectively deliver exposure will also be discussed.