Exposure Therapy for Anxiety
Northwestern University, Evanston, IL, USA and
University of Virginia, Charlottesville, VA, USA
The logic behind exposure treatments for the anxiety disorders is simple: anxious people avoid what they fear. By exposing them over a sustained period of time to the things they fear, their sense that avoidance is necessary to protect them from harm will be discontinued. Despite its simplicity, this basic method has proved to be perhaps the most powerful, specific intervention produced by psychologists to date. For all of the DSM-IV anxiety disorders, therapies which rely on exposure have produced large effects in the reduction of symptoms. They have performed at least as well as cognitive and generally better than non-directive interventions. Exposure plus response-prevention treatment has proved quite successful for obsessive-compulsive disorder, a disorder previously considered to be virtually intractable to psychological treatment (Abramowitz, 1996; Riggs & Foa, 1993). The relatively recently introduced, exposure-based treatment for panic disorder, which combines interoceptive and exteroceptive exposure, results in virtually complete remission of panic attacks in 75-90% of the patients treated, a rate high enough to support the position of this therapy as one of the treatments of choice for this disorder (Barlow, 1988; Margraf & Schneider, 1991; Margraf & Schneider, 1995; Telch, 1995). Simple phobias can be virtually cured by these means (e.g. Emmelkamp, 1994). And even for disorders such as social phobias, generalized anxiety disorder (GAD) and post-traumatic stress disorder (PSTD), in which avoidance involves more subtle patterns of thought and behavior,
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Publication information: Book title: Handbook of Cognition and Emotion. Contributors: Tim Dalgleish - Editor, Mick J. Power - Editor. Publisher: Wiley. Place of publication: New York. Publication year: 1999. Page number: 747.
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