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The interaction of therapist experiential avoidance and extraneous clinical information in predicting therapist preference for exposure treatment for OCD
Dissertation   Open access

The interaction of therapist experiential avoidance and extraneous clinical information in predicting therapist preference for exposure treatment for OCD

Stephanie J. Rabin
Doctor of Philosophy (Ph.D.), Drexel University
Apr 2013
DOI:
https://doi.org/10.17918/etd-4224
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Abstract

Anxiety--Treatment Mental Health Psychology
Despite the overwhelming evidence that the behavioral components of cognitive-behavior therapies (CBTs) are critical for patient improvement, particularly in the case of anxiety disorders, there remains a wide gap between science and practice in their consistent use. In particular, exposure therapy for anxiety is underused and frequently misunderstood, even among self-proclaimed cognitive-behavior therapists. Some have speculated that this underuse is related to therapist discomfort with and avoidance of the temporary increase in distress that patients often experience during exposure therapy, and the secondary distress that this may cause in therapists themselves. Recent studies have begun to examine therapist characteristics that are associated with the use of evidence-based psychotherapies, but these studies have focused on EBP as a whole rather than on specific interventions such as exposure, and have not addressed therapist psychological variables. In addition, there has been a great deal of research on errors and biases in psychodiagnosis and clinician decision-making regarding risk of violence, but there has been little research on factors impacting treatment planning. The current study examined the role of therapists experiential avoidance in the use of exposure-based interventions to treat a fictional patient for whom exposure therapy is clearly indicated. In addition, the study experimentally manipulated the presence of extraneous, irrelevant information in the patients presentation, and we tested whether this variable interacted with experiential avoidance in predicting clinician preference for exposure therapy. Results suggested that participants who were higher in experiential avoidance tended to allot less time to exposure therapy, r(162) = -.30, p < .001. When vignettes contained extraneous clinical information, participants tended to allot less time to exposure. There was no interaction between experiential avoidance and extraneous information. Additional therapist personality factors were associated with use of exposure therapy as well, including intuitive personality and attitudes toward evidence-based treatments.

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