Exposure therapies
Learn the most effective procedure in the field, and why it is so often diluted.
Chapter 8Sessions 11/16–11/20
What you should be able to do afterwards
- 1Explain how avoidance maintains fear
- 2Identify overt and covert safety behaviours
- 3Design an exposure that maximises expectancy violation
- 4Name the ways therapists dilute exposure and why they do it
The reading
The most consequential fact in this unit is not about the treatment but about its delivery. Exposure has among the largest effects in clinical psychology, and surveys consistently find that only a minority of clinicians treating anxiety disorders use it — and that those who do frequently permit safety behaviours, reassure mid-exposure, and stop at peak distress. The gap between what works and what is offered is a professional problem, not a scientific one.
What belongs to this unit
Questions to take away
For a seminar, a supervisor, or an argument with yourself.
- 1What would you do if a patient asked, mid-exposure, whether they were going to be all right?
- 2EMDR works and the eye movements may be inert. What should a clinician tell a patient about that?
- 3What is your own avoidance as a therapist, and how would you know?
Your notes
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