Cognitive behavior therapy for anxiety disorders: clinical tips for introducing exposure treatment

• Published in: Psychiatria et neurologia Japonica Vol. 115; no. 4; p. 421
• Main Author: Sakano, Yuji
• Format: Journal Article
• Language: Japanese
• Published: Japan 2013
• Subjects: Anxiety Disorders - therapy; Cognitive Therapy - methods; Humans; Japan; Patient Dropouts - psychology; Time Factors; Treatment Outcome; Japan
• ISSN: 0033-2658

Cognitive behavior therapy is one of the effective psychological treatments for anxiety disorders, and has been recommended as a highly ranked treatment in the treatment guidelines for various anxiety disorders. Among many cognitive behavioral techniques in cognitive behavior therapy, exposure is an essential procedure to decrease anxiety and avoidant behavior. However, difficulties in introducing exposure to patients still remain. Mistakes in introducing exposure sometimes cause patients' dropout from treatment, increase anxiety in patients, and strengthens avoidant behavior. Therefore, it is important for therapists to introduce exposure adequately, so that patients can understand the principle of exposure, conduct it, and resolve anxiety as well. In this article, some clinical tips for therapists to introduce exposure effectively are pointed out in terms of psycho-education on causes and cures of anxiety, a cognitive behavioral model of exposure, use of an anxiety hierarchy, homework assignment, self-exposure, promoting self-efficacy, coping with failure, prevention of dropout, over-learning, and self-reinforcement.