Targeting clinician concerns about exposure therapy: A pilot study comparing standard vs. enhanced training
Owing to concerns about the safety and tolerability of exposure therapy, many clinicians deliver the treatment in an overly cautious manner, which may limit its effectiveness. Although didactic training in exposure reduces clinician concerns about the treatment to a moderate extent, improved trainin...
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Veröffentlicht in: | Behaviour research and therapy 2016-10, Vol.85, p.53-59 |
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creator | Farrell, Nicholas R. Kemp, Joshua J. Blakey, Shannon M. Meyer, Johanna M. Deacon, Brett J. |
description | Owing to concerns about the safety and tolerability of exposure therapy, many clinicians deliver the treatment in an overly cautious manner, which may limit its effectiveness. Although didactic training in exposure reduces clinician concerns about the treatment to a moderate extent, improved training strategies are needed to minimize these concerns and improve exposure delivery. The present study compared the effectiveness of a standard (i.e., didactic) exposure therapy training model to an “enhanced” training paradigm encompassing strategies derived from social-cognitive theory on attitude change. Clinicians (N = 49) were assigned to one of the two training approaches. Relative to standard training, clinicians who received enhanced training showed: (a) significantly greater reductions in concerns about exposure from pre- to post-training, and (b) superior self-reported delivery of the treatment. Reduction in concerns during training mediated the effects of training condition on clinicians' self-reported exposure delivery. These findings underscore the importance of addressing clinician concerns about exposure therapy in training contexts.
•Clinicians received either standard or enhanced exposure therapy training.•Clinician concerns about exposure and self-reported exposure delivery were assessed.•Enhanced training yielded greater reductions in clinician concerns about exposure.•Self-reported exposure delivery was superior among enhanced training clinicians.•Reductions in concerns mediated the effect of training type on exposure delivery. |
doi_str_mv | 10.1016/j.brat.2016.08.011 |
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•Clinicians received either standard or enhanced exposure therapy training.•Clinician concerns about exposure and self-reported exposure delivery were assessed.•Enhanced training yielded greater reductions in clinician concerns about exposure.•Self-reported exposure delivery was superior among enhanced training clinicians.•Reductions in concerns mediated the effect of training type on exposure delivery.</description><identifier>ISSN: 0005-7967</identifier><identifier>EISSN: 1873-622X</identifier><identifier>DOI: 10.1016/j.brat.2016.08.011</identifier><identifier>PMID: 27567972</identifier><identifier>CODEN: BRTHAA</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Anxiety disorders ; Attitude of Health Personnel ; Clinical Competence ; Clinician concerns ; Cognition & reasoning ; Cognitive ability ; Comparative analysis ; Concerns ; Dissemination ; Exposure therapy ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Implosive Therapy - education ; Male ; Medical treatment ; Middle Aged ; Pilot Projects ; Professional attitudes ; Safety ; Teaching ; Training</subject><ispartof>Behaviour research and therapy, 2016-10, Vol.85, p.53-59</ispartof><rights>2016 Elsevier Ltd</rights><rights>Copyright © 2016 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Pergamon Press Inc. Oct 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-30e949ab212d15cba81873205f3602c7e7811461daccf537bdfb1ad236f78c6a3</citedby><cites>FETCH-LOGICAL-c384t-30e949ab212d15cba81873205f3602c7e7811461daccf537bdfb1ad236f78c6a3</cites><orcidid>0000-0002-9291-3688</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0005796716301425$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,30978,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27567972$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Farrell, Nicholas R.</creatorcontrib><creatorcontrib>Kemp, Joshua J.</creatorcontrib><creatorcontrib>Blakey, Shannon M.</creatorcontrib><creatorcontrib>Meyer, Johanna M.</creatorcontrib><creatorcontrib>Deacon, Brett J.</creatorcontrib><title>Targeting clinician concerns about exposure therapy: A pilot study comparing standard vs. enhanced training</title><title>Behaviour research and therapy</title><addtitle>Behav Res Ther</addtitle><description>Owing to concerns about the safety and tolerability of exposure therapy, many clinicians deliver the treatment in an overly cautious manner, which may limit its effectiveness. Although didactic training in exposure reduces clinician concerns about the treatment to a moderate extent, improved training strategies are needed to minimize these concerns and improve exposure delivery. The present study compared the effectiveness of a standard (i.e., didactic) exposure therapy training model to an “enhanced” training paradigm encompassing strategies derived from social-cognitive theory on attitude change. Clinicians (N = 49) were assigned to one of the two training approaches. Relative to standard training, clinicians who received enhanced training showed: (a) significantly greater reductions in concerns about exposure from pre- to post-training, and (b) superior self-reported delivery of the treatment. Reduction in concerns during training mediated the effects of training condition on clinicians' self-reported exposure delivery. These findings underscore the importance of addressing clinician concerns about exposure therapy in training contexts.
•Clinicians received either standard or enhanced exposure therapy training.•Clinician concerns about exposure and self-reported exposure delivery were assessed.•Enhanced training yielded greater reductions in clinician concerns about exposure.•Self-reported exposure delivery was superior among enhanced training clinicians.•Reductions in concerns mediated the effect of training type on exposure delivery.</description><subject>Adult</subject><subject>Aged</subject><subject>Anxiety disorders</subject><subject>Attitude of Health Personnel</subject><subject>Clinical Competence</subject><subject>Clinician concerns</subject><subject>Cognition & reasoning</subject><subject>Cognitive ability</subject><subject>Comparative analysis</subject><subject>Concerns</subject><subject>Dissemination</subject><subject>Exposure therapy</subject><subject>Female</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Humans</subject><subject>Implosive Therapy - education</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Pilot Projects</subject><subject>Professional attitudes</subject><subject>Safety</subject><subject>Teaching</subject><subject>Training</subject><issn>0005-7967</issn><issn>1873-622X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp9kc2OFCEUhYnROO3oC7gwJG7cVAnUD5RxM5n4l0ziZkzckVtwq4e2GkqgJvbbS6VHFy5cAcl3v3DPIeQlZzVnvH97qMcIuRblXjNVM84fkR1Xsql6Ib4_JjvGWFfJoZcX5FlKh_JslGBPyYWQXS8HKXbkxy3EPWbn99TMzjvjwFMTvMHoE4UxrJniryWkNSLNdxhhOb2jV3Rxc8g05dWeCn5cIG6KlMFbiJbep5qiv4PisTRHKGa_f06eTDAnfPFwXpJvHz_cXn-ubr5--nJ9dVOZRrW5ahgO7QCj4MLyzoygtp0E66amZ8JIlIrztucWjJm6Ro52GjlY0fSTVKaH5pK8OXuXGH6umLI-umRwnsFjWJPmSnA2yBJMQV__gx7CGn353Ua1Yhi6diiUOFMmhpQiTnqJ7gjxpDnTWxX6oLcq9FaFZkqXKsrQqwf1Oh7R_h35k30B3p8BLFncO4w6GYdbYi6iydoG9z__b3rWmyk</recordid><startdate>201610</startdate><enddate>201610</enddate><creator>Farrell, Nicholas R.</creator><creator>Kemp, Joshua J.</creator><creator>Blakey, Shannon M.</creator><creator>Meyer, Johanna M.</creator><creator>Deacon, Brett J.</creator><general>Elsevier Ltd</general><general>Elsevier Science Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9291-3688</orcidid></search><sort><creationdate>201610</creationdate><title>Targeting clinician concerns about exposure therapy: A pilot study comparing standard vs. enhanced training</title><author>Farrell, Nicholas R. ; Kemp, Joshua J. ; Blakey, Shannon M. ; Meyer, Johanna M. ; Deacon, Brett J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-30e949ab212d15cba81873205f3602c7e7811461daccf537bdfb1ad236f78c6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anxiety disorders</topic><topic>Attitude of Health Personnel</topic><topic>Clinical Competence</topic><topic>Clinician concerns</topic><topic>Cognition & reasoning</topic><topic>Cognitive ability</topic><topic>Comparative analysis</topic><topic>Concerns</topic><topic>Dissemination</topic><topic>Exposure therapy</topic><topic>Female</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Humans</topic><topic>Implosive Therapy - education</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Pilot Projects</topic><topic>Professional attitudes</topic><topic>Safety</topic><topic>Teaching</topic><topic>Training</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Farrell, Nicholas R.</creatorcontrib><creatorcontrib>Kemp, Joshua J.</creatorcontrib><creatorcontrib>Blakey, Shannon M.</creatorcontrib><creatorcontrib>Meyer, Johanna M.</creatorcontrib><creatorcontrib>Deacon, Brett J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Behaviour research and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Farrell, Nicholas R.</au><au>Kemp, Joshua J.</au><au>Blakey, Shannon M.</au><au>Meyer, Johanna M.</au><au>Deacon, Brett J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Targeting clinician concerns about exposure therapy: A pilot study comparing standard vs. enhanced training</atitle><jtitle>Behaviour research and therapy</jtitle><addtitle>Behav Res Ther</addtitle><date>2016-10</date><risdate>2016</risdate><volume>85</volume><spage>53</spage><epage>59</epage><pages>53-59</pages><issn>0005-7967</issn><eissn>1873-622X</eissn><coden>BRTHAA</coden><abstract>Owing to concerns about the safety and tolerability of exposure therapy, many clinicians deliver the treatment in an overly cautious manner, which may limit its effectiveness. Although didactic training in exposure reduces clinician concerns about the treatment to a moderate extent, improved training strategies are needed to minimize these concerns and improve exposure delivery. The present study compared the effectiveness of a standard (i.e., didactic) exposure therapy training model to an “enhanced” training paradigm encompassing strategies derived from social-cognitive theory on attitude change. Clinicians (N = 49) were assigned to one of the two training approaches. Relative to standard training, clinicians who received enhanced training showed: (a) significantly greater reductions in concerns about exposure from pre- to post-training, and (b) superior self-reported delivery of the treatment. Reduction in concerns during training mediated the effects of training condition on clinicians' self-reported exposure delivery. These findings underscore the importance of addressing clinician concerns about exposure therapy in training contexts.
•Clinicians received either standard or enhanced exposure therapy training.•Clinician concerns about exposure and self-reported exposure delivery were assessed.•Enhanced training yielded greater reductions in clinician concerns about exposure.•Self-reported exposure delivery was superior among enhanced training clinicians.•Reductions in concerns mediated the effect of training type on exposure delivery.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>27567972</pmid><doi>10.1016/j.brat.2016.08.011</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-9291-3688</orcidid></addata></record> |
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subjects | Adult Aged Anxiety disorders Attitude of Health Personnel Clinical Competence Clinician concerns Cognition & reasoning Cognitive ability Comparative analysis Concerns Dissemination Exposure therapy Female Health Knowledge, Attitudes, Practice Humans Implosive Therapy - education Male Medical treatment Middle Aged Pilot Projects Professional attitudes Safety Teaching Training |
title | Targeting clinician concerns about exposure therapy: A pilot study comparing standard vs. enhanced training |
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