Handbook of Exposure Therapies (eBook)

Cover 1
Copyright page 5
Table of Contents 6
Contributors 10
Preface 18
Chapter 1: Description, Mechanisms of Action, and Assessment 22
What is Exposure Therapy? 23
Mechanisms of Action 29
Assessment 39
Summary 45
References 46
Chapter 2: Animal Models of Exposure Therapy: A Selective Review 50
Basic Types of Exposure Therapy 52
Animal Models 54
Conclusion 70
References 70
Chapter 3: Exposure Therapy and Cognitive Interventionsfor the Anxiety Disorders: Overview and Newer Third-Generation Perspectives 82
Rationales of First- and Second- Generation Behavior Therapy 83
Mechanisms and Processes Underlying Therapeutic Change 88
Treatment Efficacy 91
Emotion Regulation and the Anxiety Disorders 102
Basic and Applied Implications 112
References 120
Chapter 4: Translational Research Perspectives on Maximizingthe Effectiveness of Exposure Therapy 130
Context Effects in Clinicals Studies 132
Clinical Implications of Context Effects 133
Exposure Parameters from a Context Perspective 135
Concluding Comments 142
References 143
Chapter 5: Exposure Therapy and Post-Traumatic Stress Disorder 148
Definition of PTSD 149
Theories of PTSD 150
Exposure Therapy 154
Thoughts for the Future 166
References 168
Chapter 6: Exposure Therapy with Adult Survivors of Childhood Sexual Abuse 174
Theoretical Explanations of the Response to CSA 175
Exposure Therapy with CSA Survivors 177
Outcome Research 178
Special Considerations for CSA Survivors 181
Summary and Conclusions 186
References 187
Chapter 7: Issues in Conducting Exposure Therapy to Treat Combat Veterans’ PTSD 190
Selection and Timing of Exposure as the Treatment of Choice 192
Treatment Implementation 197
Conclusion 203
References 204
Chapter 8: Exposure Therapy for Obsessive-Compulsive Disorder 206
From Theory to Therapy 207
Implementation of Exposure-Based Therapy for OCD 209
Types of Imaginal Exposure 210
Habituation of Anxiety During Exposure 210
Procedural Variations 211
Delivering ERP 211
Using Cognitive Techniques During Exposure Therapy 212
Mechanisms of Action 212
The Efficacy of ERP 213
Predictors of Treatment Outcome 216
Combining Medications with Exposure Therapy for OCD 217
Case Description 217
Clinical Case Conceptualization 218
Treatment Implementation 220
Assessment 223
Results 224
Discussion 225
Summary and Conclusions 226
References 227
Chapter 9: Cognitive-Behavior Therapy and the Treatmentof Childhood Obsessive-Compulsive Disorder 230
Case Study: Suzie 231
References 240
Chapter 10: Exposure Treatments for Panic Disorderwith and without Agoraphobia 242
Interoceptive Exposure 244
Invivo Exposure 245
Panic Control Treatment 245
Cognitive Therapy 246
Treatment Efficacy 246
Combined Cognitive-Behavioral and Psychopharmacological Interventions 247
Invivo Exposure for Agoraphobia 248
Group Dismantling Studies for Panic Control Treatment 250
Barriers to Effective Exposure Therapy 256
Case study 259
Summary and Conclusions 263
References 263
Chapter 11: Exposure Therapy for Phobias 268
Specific Phobia and Exposure-Based Treatment: Overview 268
Spider Phobia 269
Blood-Injection-Injury (BII) Phobia 276
Claustrophobia 279
Flying Phobia 281
Social Phobia 283
Conclusions 286
References 287
Chapter 12: Applications of Exposure Techniquesin Behavioral Medicine 292
Specific Phobia, Blood-Injection-Injury Type 293
Historical Overview 294
Contemporary Trends 295
Clinical Issues 297
Specific Phobia, Dental Phobia Type 299
Pain Anxiety 304
Written Exposure/Emotional Disclosure 310
Conclusion 312
References 313
Chapter 13: Exposure Therapy for Hypochondriasis 320
Case Study: Matt 323
References 329
Chapter 14: The Effect of Pharmacotherapy on the Effectiveness of Exposure Therapy 332
Review of Studies on Combined Treatments for Anxiety Disorders 334
Issues that Arise in Combined Treatment 344
Concluding Comments 350
References 350
Chapter 15: Pharmacological Enhancement of Learning in Exposure Therapy 356
Extinction is a Neural Mechanism that may Underlie Exposure Therapy 356
Extinction Involves New Emotional Learning 358
Pharmacological Enhancement of Extinction in Animal Models 359
Pharmacological Enhancement of Behavioral Exposure Therapy for Acrophobia 360
Future Directions 364
Conclusions 364
References 365
Chapter 16: Virtual Reality Applications for Exposure 368
What is Invirtuo Exposure? 368
Canvr Induce Anxiety? 372
Efficacy of in Virtuo Exposure 374
Fear of Flying 374
Spider Phobia 378
Fear of Public Speaking and Social Anxiety 380
Fear of Heights 381
Post-Traumatic Stress Symptoms and Post-Traumatic Stress Disorder 383
Driving Phobia 384
Panic Disorder With Agoraphobia 385
Claustrophobia 385
Summary of Outcome Studies 386
Issues In VR Treatment 387
Case History 392
Conclusion 400
References 403
Chapter 17: Obstacles to Successful Implementation of Exposure Therapy 410
The Dissemination Barrier 410
Myths and Manualized Treatments 412
The Implementation Barrier 419
Conclusion 426
References 427
Chapter 18: Exposure Therapy Has a Public Relations Problem: A Dearth of Litigation Amid a Wealth of Concern 430
Law, Ethics, and Professional Issues in Exposure Therapy 430
Method 433
Results 436
Discussion 442
References 446
Appendix: Exposure Survey for Outpatients and Students 448
Index 452