The Art of Exposure: Putting Science Into Practice

• Published in: Cognitive and behavioral practice Vol. 22; no. 3; pp. 379 - 392
• Main Authors: Peterman, Jeremy S., Read, Kendra L., Wei, Chiaying, Kendall, Philip C.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-08-2015
• Subjects: anxiety; cognitive-behavioral therapy; exposure; exposure; anxiety; cognitive-behavioral therapy
• ISSN: 1077-7229; 1878-187X
• DOI: 10.1016/j.cbpra.2014.02.003

Behavioral exposure has been identified as an integral component of successful cognitive behavioral therapy (CBT) for youth with distressing anxiety. Despite the evidence supporting the efficacy of exposures, they are often underutilized in community settings. Although flexible implementation of exposures is recommended, specific guidelines on how to execute individualized exposures are largely lacking. The following paper outlines ways to adapt and tailor exposures to the individual presentation, translating the process into meaningful therapeutic gains. First, the article reviews creative methods to promote youth's motivation and engagement (e.g. through the use of games, technology, and other personalization strategies). Second, the paper outlines generalization of exposure into the child's daily life (e.g. at home, at school, and overtime). The paper concludes with a discussion of areas for future exposure-related research.
•Exposure is an instrumental component of cognitive-behavioral therapy for youth anxiety.•Exposure is a well-tolerated and safe tool, yet it is underused by community clinicians.•Exposures are meant to be tailored to the youth’s presenting concern, interests, and developmental level.•There are several ways to engage youth in exposure: making them into games, personalizing, and incorporating technology.•Therapists can generalize therapy gains by facilitating exposures at the youth’s home and school.