A Preliminary Exploration of the Barriers to Delivering (and Receiving) Exposure-Based Cognitive Behavioral Therapy for Anxiety Disorders in Adult Community Mental Health Settings
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Despite the effectiveness of exposure-based cognitive behavioral therapy (CBT) for anxiety disorders, few individuals in need receive this treatment, particularly in community mental health settings serving low-income adults. The present study took a preliminary step to understand these barriers by conducting a series of key informant interviews and focus groups among patients, providers, clinical administrators, and policy makers. Several themes emerged as barriers to the delivery of exposure-based CBT in these settings, including therapist training and compentency issues, logistical issues, and funding stream issues. Clinical implications and future research that can build from these data are discussed.
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Prior qualitative research with specialty care BHPs in pediatric and adult populations found lack of advanced training and supervision, treatment structure, and time constraints as provider barriers to using CBT for anxiety including exposure.
“Research conducted with specialty care BHPs in both pediatric (Ringle et al., 2015) and adult (Wolitzky-Taylor et al., 2018) populations found lack of advanced training and supervision, treatment structure, and time constraints as provider barriers to using CBT for anxiety including exposure”
From Barriers to and Facilitators of Using Evidence-Based, Cognitive–Behavioral Anxiety Interventions in Integrated Primary Care Practice (2023) · cites this paper as Wolitzky-Taylor et al., 2018
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Experimental — accuracy not yet measuredSimilar to prior work in specialty care, BHPs in IPC settings identified barriers and facilitators to using cognitive-behavioral anxiety interventions at multiple levels spanning the IPC model, provider, and patient.
“Similar to prior work in specialty care (Wolitzky-Taylor et al., 2018; Youn et al., 2020), BHPs in IPC settings identified barriers and facilitators to using cognitive-behavioral anxiety interventions at multiple levels spanning the IPC model, provider, and patient.”
From Barriers to and Facilitators of Using Evidence-Based, Cognitive–Behavioral Anxiety Interventions in Integrated Primary Care Practice (2023) · cites this paper as Wolitzky-Taylor et al., 2018
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Cites
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.593 · Cited by 20,391 · see citing works
(2006) · Cited by 18,730 · see citing works
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009) · Implementation Science · doi:10.1186/1748-5908-4-50 · Cited by 14,496 · see citing works
Journal of Clinical Psychiatry
(2018) · Journal of Clinical Psychiatry · doi:10.5505/kpd · Cited by 13,703 · see citing works
(2005) · PubMed · Cited by 7,011 · see citing works
Advancing a Conceptual Model of Evidence-Based Practice Implementation in Public Service Sectors
Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-010-0327-7 · Cited by 3,240 · cited 1× · see citing works
“In line with conceptual models of implementation science (Aarons et al. 2011; Damschroder et al. 2009), and in particular the exploration and preparation phase of the Exploration, Preparation, Implementation, Sustainment (EPIS) model, we outline putative barriers deserving of consideration at multiple system levels (i.”
BackgroundPrevalence and Treatment of Mental Disorders, 1990 to 2003
Kessler, R. C., Demler, O., Frank, R. G., Olfson, M., Pincus, H. A., Walters, E. E., Wang, P., Wells, K. B., & Zaslavsky, A. M. (2005) · New England Journal of Medicine · doi:10.1056/nejmsa043266 · Cited by 1,910 · see citing works
“The Medical Journal of Australia”
(1923) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1923.tb64467.x · Cited by 1,549 · see citing works
Hoffman, S. G., & Smits, J. A. J. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0415 · Cited by 1,420 · see citing works
The economic burden of anxiety disorders in the 1990s
Greenberg, P. E., Sisitsky, T., Kessler, R. C., Finkelstein, S. N., Berndt, E. R., Davidson, J. R. T., Ballenger, J. C., & Fyer, A. J. (1999) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v60n0702 · Cited by 1,242 · cited 1× · see citing works
“Anxiety disorders1 are among the most prevalent mental disorders, and are chronic, costly, and disabling (Kessler et al. 2005; Stein et al. 2015; Greenberg et al. 1999).”
BackgroundThe quality of care for depressive and anxiety disorders in the United States
Young, A. S., Klap, R., Sherbourne, C. D., & Wells, K. B. (2001) · Archives of General Psychiatry · doi:10.1001/archpsyc.58.1.55 · Cited by 1,061 · see citing works
Disparity in Depression Treatment Among Racial and Ethnic Minority Populations in the United States
Alegría, M., Chatterji, P., Wells, K., Cao, Z., Chen, C.-N., Takeuchi, D., Jackson, J., & Meng, X.-L. (2008) · Psychiatric Services · doi:10.1176/ps.2008.59.11.1264 · Cited by 993 · see citing works
Weisz, J. R. (2012) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.147 · Cited by 827 · see citing works
Quality of life in the anxiety disorders: a meta-analytic review
Olatunji, B. O., Cisler, J. M., & Tolin, D. F. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.01.015 · Cited by 808 · see citing works
A survey of psychologists’ attitudes towards and utilization of exposure therapy for PTSD
Becker, C. B., Zayfert, C., & Anderson, E. (2004) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00138-4 · Cited by 759 · see citing works
Potential barriers to the use of health services among ethnic minorities: A review
Scheppers, E. (2006) · Family Practice · doi:10.1093/fampra/cmi113 · Cited by 759 · see citing works
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: A Randomized Controlled Trial
Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., Gallagher, M. W., & Barlow, D. H. (2012) · Behavior Therapy · doi:10.1016/j.beth.2012.01.001 · Cited by 746 · see citing works
Generalized anxiety disorder: prevalence, burden, and cost to society
Wittchen, H.-U. (2002) · Depression and Anxiety · doi:10.1002/da.10065 · Cited by 733 · see citing works
Is cognitive–behavioral therapy more effective than other therapies?
Tolin, D. F. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.05.003 · Cited by 645 · see citing works
Stewart, R. E., & Chambless, D. L. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0016032 · Cited by 483 · see citing works
Insel, T. R. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2008.540 · Cited by 459 · see citing works
Roy-Byrne, P., Craske, M. G., Sullivan, G., Rose, R. D., Edlund, M. J., Lang, A. J., Bystritsky, A., Welch, S. S., Chavira, D. A., Golinelli, D., et al. (2010) · JAMA · doi:10.1001/jama.2010.608 · Cited by 452 · see citing works
National Survey of Psychotherapy Training in Psychiatry, Psychology, and Social Work
Weissman, M. M., Verdeli, H., Gameroff, M. J., Bledsoe, S. E., Betts, K., Mufson, L., Fitterling, H., & Wickramaratne, P. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.8.925 · Cited by 422 · see citing works
Cognitive and behavioral treatments for anxiety disorders: A review of meta‐analytic findings
Deacon, B. J., & Abramowitz, J. S. (2004) · Journal of Clinical Psychology · doi:10.1002/jclp.10255 · Cited by 400 · cited 5× · see citing works
“Behavioral and cognitive-behavioral therapies (CBT) that involve gradual confrontation with feared stimuli (known as exposure) represent the most established and efficacious evidence-based psychosocial treatments for this group of disorders, showing large effects in both efficacy and effectiveness studies (Deacon and…”
BackgroundInfluentialBorntrager, C. F., Chorpita, B. F., Higa-McMillan, C., & Weisz, J. R. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.5.677 · Cited by 277 · see citing works
The Cruelest Cure? Ethical Issues in the Implementation of Exposure-Based Treatments
Olatunji, B. O., Deacon, B. J., & Abramowitz, J. S. (2009) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2008.07.003 · Cited by 273 · cited 1× · see citing works
“In contrast to previous work (Olatunji et al. 2009; Becker et al. 2004; Deacon and Farrell 2013), negative attitudes about exposurebased CBT for anxiety did not emerge as a major barrier.”
ResultAcker, G. M. (2004) · Community Mental Health Journal · doi:10.1023/b:comh.0000015218.12111.26 · Cited by 245 · see citing works
Why do clinicians exclude anxious clients from exposure therapy?
Meyer, J. M., Farrell, N. R., Kemp, J. J., Blakey, S. M., & Deacon, B. J. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.01.004 · Cited by 185 · see citing works
Dissemination of Evidence-Based Practices for Anxiety Disorders in Wyoming
Hipol, L. J., & Deacon, B. (2013) · Behavior Modification · doi:10.1177/0145445512458794 · Cited by 169 · see citing works
Braga, R. J., Mendlowicz, M. V., Marrocos, R. P., & Figueira, I. L. D. V. (2004) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2004.09.003 · Cited by 161 · see citing works
Efficacy of modular cognitive behavior therapy for childhood anxiety disorders
Chorpita, B. F., Taylor, A. A., Francis, S. E., Moffitt, C., & Austin, A. A. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80039-x · Cited by 148 · see citing works
Disseminating and Implementing Trauma-Focused CBT in Community Settings
Cohen, J., & Mannarino, A. (2008) · Trauma, Violence, & Abuse · doi:10.1177/1524838008324336 · Cited by 142 · see citing works
D, D. M. M., Fortney, J. C., Pyne, J. M., Edlund, M. J., & Wetherell, J. L. (2006) · Psychiatric Services · doi:10.1176/appi.ps.57.12.1731 · Cited by 110 · see citing works
Hofmann, S. G., Sawyer, A. T., Korte, K. J., & Smits, J. A. J. (2009) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2009.2.2.160 · Cited by 109 · see citing works
MAPping Los Angeles County: Taking an Evidence-Informed Model of Mental Health Care to Scale
Southam‐Gerow, M. A., Daleiden, E. L., Chorpita, B. F., Bae, C., Mitchell, C., Faye, M., & Alba, M. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.833098 · Cited by 104 · see citing works
Wolitzky-Taylor, K., Zimmermann, M., Arch, J. J., De Guzman, E., & Lagomasino, I. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.06.010 · Cited by 104 · see citing works
Self-citationTherapist perceptions and delivery of interoceptive exposure for panic disorder
Deacon, B. J., Lickel, J. J., Farrell, N. R., Kemp, J. J., & Hipol, L. J. (2013) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2013.02.004 · Cited by 101 · cited 1× · see citing works
“Beliefs such as these have been identified in prior studies investigating community therapists’ beliefs about exposure therapy for anxiety disorders (Deacon et al. 2013; Meyer et al. 2014).”
BackgroundBrown, A. M., Deacon, B. J., Abramowitz, J. S., Dammann, J., & Whiteside, S. P. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2006.04.010 · Cited by 94 · see citing works
Therapist Barriers to the Dissemination of Exposure Therapy
Deacon, B. J., & Farrell, N. R. (2013) · Handbook of Treating Variants and Complications in Anxiety Disorders · doi:10.1007/978-1-4614-6458-7_23 · Cited by 91 · see citing works
Patients' perceptions of pharmacological and cognitive-behavioral treatments for anxiety disorders
Deacon, B. J., & Abramowitz, J. S. (2005) · Behavior Therapy · doi:10.1016/s0005-7894(05)80062-0 · Cited by 78 · see citing works
Feeny, N. C., Zoellner, L. A., Mavissakalian, M. R., & Roy-Byrne, P. P. (2009) · Depression and Anxiety · doi:10.1002/da.20588 · Cited by 72 · see citing works
Dwight‐Johnson, M., Lagomasino, I. T., Hay, J. W., Zhang, L., Tang, L., Green, J. M., & Duan, N. (2010) · Psychiatric Services · doi:10.1176/ps.2010.61.11.1112 · Cited by 71 · see citing works
Dissemination and implementation of prolonged exposure therapy for posttraumatic stress disorder
McLean, C. P., & Foa, E. B. (2013) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2013.03.004 · Cited by 65 · see citing works
Global mental health and neuroscience: potential synergies
Stein, D. J., He, Y., Phillips, A. G., Sahakian, B. J., Williams, J. H. H., & Patel, V. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00014-0 · Cited by 59 · see citing works
Direct-to-consumer marketing of psychological treatments for anxiety disorders
Gallo, K. P., Comer, J. S., & Barlow, D. H. (2013) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2013.03.005 · Cited by 59 · see citing works
Direct-to-Consumer Marketing of Evidence-Based Psychological Interventions
Santucci, L. C., McHugh, R. K., & Barlow, D. H. (2011) · Behavior Therapy · doi:10.1016/j.beth.2011.07.003 · Cited by 57 · see citing works
(2007) · PubMed · Cited by 51 · see citing works
The credibility of exposure therapy: Does the theoretical rationale matter?
Arch, J. J., Twohig, M. P., Deacon, B. J., Landy, L. N., & Bluett, E. J. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.05.008 · Cited by 47 · cited 2× · see citing works
“Lacking knowledge of exposure-based treatment (Arch et al. 2015), adults in our communities with anxiety disorders cannot make informed decisions about their mental health care.”
BackgroundSelf-citationQualitative Social Work Research
Padgett, D. K. (2012) · SAGE Publications Ltd eBooks · doi:10.4135/9781446247648.n30 · Cited by 46 · see citing works
Berzin, S. C., & O'Connor, S. (2010) · Children & Schools · doi:10.1093/cs/32.4.237 · Cited by 40 · see citing works
Is internet treatment for depressive and anxiety disorders ready for prime time?
Andrews, G., & Titov, N. (2010) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2010.tb03693.x · Cited by 37 · see citing works
Karekla, M., Lundgren, J. D., & Forsyth, J. P. (2004) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(04)80034-8 · Cited by 34 · see citing works
Wolitzky-Taylor, K., Chung, B., Bearman, S. K., Arch, J., Grossman, J., Fenwick, K., Lengnick-Hall, R., & Miranda, J. (2019) · Community Mental Health Journal · doi:10.1007/s10597-018-0250-z · Cited by 30 · see citing works
Self-citationPidano, A. E., & Whitcomb, J. M. (2012) · Training and Education in Professional Psychology · doi:10.1037/a0026961 · Cited by 15 · see citing works
Évaluation économique de la thérapie cognitivo-comportementale des troubles anxieux.
Roberge, P., Marchand, A., Reinharz, D., Marchand, L., & Cloutier, K. (2004) · Canadian Psychology/Psychologie canadienne · doi:10.1037/h0086988 · Cited by 10 · see citing works
Flagged first, then by citations
2 of the 57 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Lilienfeld SO Lynn SJ Lohr JM 2003 Pseudoscience is alive and well The Scientific Review of Mental Health Practice 2 107 110
Cited by
Sorted by citations
Videoconferencing psychological therapy and anxiety: a systematic review
Berryhill, M. B., Halli-Tierney, A., Culmer, N., Williams, N., Betancourt, A., King, M., & Ruggles, H. (2019) · Family Practice · doi:10.1093/fampra/cmy072 · Cited by 143 · see citing works
Liu, W., Hou, S., Zhang, Q., Yu, S., Zhao, L., Li, H., Wang, Y., & Liu, X. (2025) · Trends in Food Science & Technology · doi:10.1016/j.tifs.2025.105468 · Cited by 56 · see citing works
Human Support in App-Based Cognitive Behavioral Therapies for Emotional Disorders: Scoping Review
Bernstein, E. E., Weingarden, H. M., Wolfe, E. C., Hall, M. D., Snorrason, Í., & Wilhelm, S. (2022) · Journal of Medical Internet Research · doi:10.2196/33307 · Cited by 55 · see citing works
Trivasse, H., Webb, T. L., & Waller, G. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101887 · Cited by 51 · see citing works
Stech, E. P., Lim, J., Upton, E. L., & Newby, J. M. (2020) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2019.1628808 · Cited by 43 · see citing works
“Contributing factors to the low provision of CBT for anxiety include lack of clinician training and competence, clinician biases, organisational barriers, and logistical barriers at a patient level (Wolitzky-Taylor et al., 2018).”
BackgroundWolitzky-Taylor, K., Chung, B., Bearman, S. K., Arch, J., Grossman, J., Fenwick, K., Lengnick-Hall, R., & Miranda, J. (2019) · Community Mental Health Journal · doi:10.1007/s10597-018-0250-z · Cited by 30 · see citing works
Self-citationEfficacy and Safety of Psychedelics in Treating Anxiety Disorders
Feulner, L., Sermchaiwong, T., Rodland, N., & Galarneau, D. W. (2023) · Ochsner Journal · doi:10.31486/toj.23.0076 · Cited by 28 · see citing works
“14,17,18 Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are first-line pharmacologic agents for the treatment of anxiety disorders, 19 but some patients do not respond adequately to treatment with these agents and may develop a…”
BackgroundFeasibility trial of the school‐based STRONG intervention to promote resilience among newcomer youth
Crooks, C. V., Hoover, S., & Smith, A. C. G. (2020) · Psychology in the Schools · doi:10.1002/pits.22366 · Cited by 27 · see citing works
Systemic limitations in the delivery of mental health care in prisons in England
Patel, R., Harvey, J., & Forrester, A. (2018) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2018.06.003 · Cited by 27 · see citing works
Williams, M., Honan, C., Skromanis, S., Sanderson, B., & Matthews, A. J. (2024) · Current Psychology · doi:10.1007/s12144-023-04695-x · Cited by 25 · see citing works
“Further, factors such as financial cost, delivery mode, and client treat-ment preference present as barriers to accessing this treat-ment or other face-to-face therapies (Andersson & Titov, 2014; Wolitzky-Taylor et al., 2018).”
Peterson, R. S., Darnell, D. A., Berliner, L., Dorsey, S., Murray, L. K., & Monroe‐DeVita, M. (2018) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-018-9631-x · Cited by 14 · see citing works
Shepardson, R. L., Fletcher, T. L., Funderburk, J. S., Weisberg, R. B., Beehler, G. P., & Maisto, S. A. (2023) · Psychological Services · doi:10.1037/ser0000696 · Cited by 13 · see citing works
Clinician-Reported Determinants of Evidence-Based Practice Use in Private Practice Mental Health
Milgram, L., Freeman, J. B., Benito, K., Elwy, A. R., & Frank, H. E. (2022) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-022-09551-w · Cited by 12 · see citing works
Woodard, G. S., Triplett, N. S., Frank, H. E., Harrison, J. P., Robinson, S., & Dorsey, S. (2021) · Implementation Research and Practice · doi:10.1177/26334895211057883 · Cited by 11 · see citing works
“A uthor M anuscript A uthor M anuscript A uthor M anuscript A uthor M anuscript A primary barrier to the implementation of exposure therapy in CMH settings is a lack of clinician training (Reid et al., 2017a, 2017b; Wolitzky-Taylor et al., 2018).”
BackgroundAnxiety interventions delivered in primary care behavioral health routine clinical practice
Shepardson, R. L., Minnick, M. R., & Funderburk, J. S. (2020) · Families, Systems, & Health · doi:10.1037/fsh0000493 · Cited by 10 · see citing works
“Barriers to using exposure in PCBH are likely similar to those in specialty care, including training deficiencies, time constraints, and provider concerns about patients feeling anxious during exposure (Wolitzky-Taylor et al., 2018).”
BackgroundKwek, S. Q., Yeo, T. M., Teo, J. Y. C., Seah, A. C. W., Kai Ning, J. P., & Wang, W. (2025) · European Journal of Cardiovascular Nursing · doi:10.1093/eurjcn/zvaf084 · Cited by 11 · see citing works
Williams, M., Honan, C., Skromanis, S., Sanderson, B., & Matthews, A. J. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.12.009 · Cited by 8 · see citing works
Sensa Mobile App for Managing Stress, Anxiety, and Depression Symptoms: Pilot Cohort Study
Valinskas, S., Nakrys, M., Aleknavičius, K., & Jonusas, J. (2023) · JMIR Formative Research · doi:10.2196/40671 · Cited by 9 · see citing works
“However, the need for an experienced practitioner and the time and resources needed to prepare one slows down the widespread implementation of this method in general practice [23].”
BackgroundTherapist Perceptions of Experiential Training for Exposure Therapy
Frank, H. E., Rifkin, L. S., Sheehan, K. G., Becker‐Haimes, E. M., Crane, M. E., Phillips, K. E., Palitz, S. A., Kemp, J. J., Benito, K., & Kendall, P. C. (2021) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465822000728 · Cited by 9 · see citing works
Serowik, K. L., Roemer, L., Suvak, M., Liverant, G., & Orsillo, S. M. (2020) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2020.1765858 · Cited by 7 · see citing works
Supporting Clinicians in Implementing Exposure Therapy for Anxiety and Related Disorders
Frank, H. E., Woodard, G., & Martinez, R. G. (2025) · Current Psychiatry Reports · doi:10.1007/s11920-025-01612-w · Cited by 3 · see citing works
Krieger, A. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1569416 · Cited by 6 · see citing works
Nardo, E., Parchuri, E., O’Brien, J. A., Crosby, L. E., Porter, J. S., Palermo, T. M., Nikolajski, C., Treadwell, M. J., Hillery, C. A., Szigethy, E., et al. (2023) · BMC Digital Health · doi:10.1186/s44247-023-00051-y · Cited by 4 · see citing works
Parchuri, E., Nardo, E., O’Brien, J. A., Crosby, L. E., Porter, J. S., Palermo, T. M., Nikolajski, C., Treadwell, M. J., Hillery, C. A., Szigethy, E., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-3073103/v1 · Cited by 4 · see citing works
Becker‐Haimes, E. M., Rodríguez, J. H., & Wolk, C. B. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1248996 · Cited by 4 · see citing works
Digital Cognitive Behavioral Treatment for Generalized Anxiety Disorder
Parsons, E. M., Ball, T. M., Carl, J. R., Henry, A. L., Emsley, R., Miller, C. B., Wong, E. Y., Coombs, E., Collins, D., Long, L. J., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.48884 · Cited by 3 · see citing works
IJdema, T., Laceulle, O. M., Dibbets, P., & Korrelboom, K. (2023) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2023.100311 · Cited by 3 · see citing works
Ferguson, I., George, G. C., Narine, K., Turner, A., McGhee, Z., Bajwa, H., Hart, F. G., Carter, S. E., & Beard, C. (2024) · JMIR Mental Health · doi:10.2196/56758 · Cited by 3 · see citing works
“…mental health interventions (DMHIs) can overcome the most common barriers to receiving traditional mental health treatment (eg, availability of a provider, cost, transportation, and stigma) [6-9], the DMHI field has not yet realized its potential to increase access to evidence-based interventions.”
BackgroundKwee, C. M. B., & van den Hout, M. (2019) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2018.11.003 · Cited by 3 · see citing works
White, E. J., Wray, J. M., & Shepardson, R. L. (2020) · Families Systems & Health · doi:10.1037/fsh0000543 · Cited by 3 · see citing works
Freeman, J. B., Kemp, J. J., O’Connor, E., Herren, J. A., Georgiadis, C., Righi, G., & Benito, K. (2024) · JAACAP Open · doi:10.1016/j.jaacop.2024.06.005 · Cited by 2 · see citing works
“64 In addition, the delivery of this treatment most often involves weekly of fi ce visits, which can create additional barriers such as limited accessibility (ie, transportation issues, work con fl ict) or dif fi culties translating therapeutic exercises to the home.”
Tailoring Interoceptive Exposure for Patients With Medical Comorbidities
Farris, S. G., Kibbey, M. M., Derby, L., Keller, B., Hoyt, D. L., Brinkman, H. R., Alderman, B. L., & Leyro, T. M. (2024) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2024.11.001 · Cited by 2 · see citing works
McCarty, R. J., Downing, S. T., Guastello, A. D., Lazaroe, L. M., Ordway, A. R., Mirhosseini, T., Barthle-Herrera, M. A., Cooke, D. L., Mathews, C. A., & McNamara, J. P. H. (2023) · Behavior Therapy · doi:10.1016/j.beth.2023.08.006 · Cited by 2 · see citing works
Gratitude Interventions in Individuals With Diabetes
Koerner, R., Valente, O., Tao, A., & Rechenberg, K. (2025) · Holistic Nursing Practice · doi:10.1097/hnp.0000000000000732 · Cited by 2 · see citing works
Otto, M. W., Long, L. J., Papini, S., Culver, T., Taylor, C. T., Rubin, M., Fitzgerald, H. E., Liu, Q., Smits, J. A. J., Anderson, R., et al. (2025) · JMIR Research Protocols · doi:10.2196/80010 · Cited by 1 · see citing works
“The accurate identification of markers of EXCBT’s acute efficacy is important given that EXCBT is a limited resource, with evidence that only a minority of individuals receive EXCBT for anxiety-related disorders despite its status as a first-line treatment 69-71].”
Supervision in Cognitive Behavioral Therapy: Theory, Practice, Culture, and Ethics
Terjesen, M. D., Ford, A. J., Allen, K., Lin, K., Yellico, M., & Walsh, O. A. (2023) · Springer eBooks · doi:10.1007/978-3-031-33735-2_1 · Cited by 1 · see citing works
Cognitive Behavioral Therapy App, Resting State Functional Connectivity, and Anxiety
Jaywant, A., Bress, J. N., Lynch, C. J., Mir, Z., Schier, M. M., Bukhari, H., Brown, H., Falk, A. E., Bennett, S. M., Perlis, R. H., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.24498 · Cited by 1 · see citing works
Ferguson, I., George, G. C., Narine, K., Turner, A., McGhee, Z., Bajwa, H., Hart, F. G., Carter, S. E., & Beard, C. (2023) · SSRN Electronic Journal · doi:10.2139/ssrn.4668552 · Cited by 1 · see citing works
Learning gains from a one-day training in acceptance-based behavior therapy
Gu, G., Roemer, L., Suvak, M., Liverant, G., & Orsillo, S. M. (2021) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2020.1829026
“, 2014, for a review), most individuals with anxiety disorders fail to receive adequate treatment in part due to a limited supply of trained treatment providers (e.g. Weisberg et al., 2014; Wolitzky-Taylor et al., 2018).”
BackgroundCanine-Assisted Exposure Therapy
Bono, S. B. (2021) · Digital Commons - DU (University of Denver)
Using Inhibitory Learning Theories to Optimise Treatment for Children with Anxiety Disorders
Chen, W., Aji, M., Lim, C. Y. S., Songco, A., & Hudson, J. L. (2024) · Current topics in behavioral neurosciences · doi:10.1007/7854_2024_553
Pawar, P., Xie, S. M., Varghese, A. R., Smith, A., Gao, J., Kamp, E. V., Kirklin, K., Jones, B. S., Meador, W. R., & Yuen, H. K. (2025) · Healthcare · doi:10.3390/healthcare13101104
“However, financial limitations or difficulty finding competent counselors may limit access, and some PwMS may hesitate to utilize these resources due to social stigma, transportation issues, or mobility limitations from their health condition [30].”
齐, 晗. (2025) · Journal of Clinical Personalized Medicine · doi:10.12677/jcpm.2025.44435
Ovalles, A., Parsons, E. M., Steinberg, M., Ball, T. M., Edwards, R. R., Checko, E. R., Carl, J. R., Smits, J. A. J., & Otto, M. W. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2025.2564817
“However, individuals with anxiety often struggle to access CBT due to the limited availability of trained therapists, the costs and travel burden of in-person therapy, and the stigma related to treatment (Gunter & Whittal, 2010; Karlin, 2021; Wolitzky-Taylor et al., 2018).”
Lewis, C., Thomas, B. J., Yun, J. W. S., Cloître, M., Karatzias, T., Roberts, N. P., Kitchiner, N., & Bisson, J. I. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2605806
“A significant barrier to delivering CBT-TF is the high cost of in-person therapy, which often limits access to treatment (Wolitzky-Taylor et al., 2018).”
Flores-Tremblay, T., & Belleville, G. (2026) · doi:10.2196/preprints.95073
Wannemüller, A., Beckers, A., Beideck, L., Horzela, C., Hötzel, K., Jansen, A., Jordan, D., Liebert, E., Mertens, M., Rosenkranz, P., et al. (2026) · Psychotherapy and Psychosomatics · doi:10.1159/000550395
Jonathan, G., Jaroszewski, A. C., Arcese, H. T., Bailen, N. H., Snorrason, Í., Chosak, A., Ragan, J. D., Sprich, S. E., Rassmussen, J., Bernstein, E. E., et al. (2026) · doi:10.2196/preprints.98393
Wang, Z., Tong, H. Q., Yue, J., Wu, S., Xia, Y., Zhang, H., & Yang, Y. (2026) · Journal of Medical Internet Research · doi:10.2196/91751
“However, its uptake in routine care remains limited by constraints in training and supervision, underdevel-oped service infrastructure, and practical barriers to patient participation [12,13].”
Hugunin, J., Emslie, G. J., Kennard, B., Elwy, A. R., Barker, D., Arnold, T. L., Dougherty, Q. H., Whiteley, L., & Brown, L. K. (2026) · Implementation Science · doi:10.1186/s13012-026-01528-w
Powell, Z., Allen, A., Davis, C., Gisnarian, A., Jellesma, F., Ramos‐Cejudo, J., Salguero, J. M., Balcombe, L., Vorobev, A., Ivanova, E., et al. (2026) · Behaviour and Information Technology · doi:10.1080/0144929x.2026.2706675
White, S. W., Bui, C., Friedman, N. R., Carlson, C., Hudnall, M., & Powell, N. P. (2026) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2026.2711439
AI-Generated Exposure Hierarchies for Body Dysmorphic Disorder: Proof-of-Concept Study (Preprint)
Jonathan, G., Jaroszewski, A. C., Arcese, H. T., Bailen, N. H., Snorrason, Í., Chosak, A., Ragan, J. D., Sprich, S. E., Rassmussen, J., Bernstein, E. E., et al. (2026) · JMIR Formative Research · doi:10.2196/98393
Affirmative Cognitive Behavioral Therapy
Craig, D. S. L. (2026) · doi:10.1093/9780197778654.003.0001
Craig, D. S. L. (2026) · doi:10.1093/9780197778654.002.0006
Working With Specific Populations and Clinical Modalities
Austin, D. A., Yang, D. W., & Craig, D. S. L. (2026) · doi:10.1093/9780197778654.003.0004
Troubleshooting Common Clinical Challenges
Craig, S. L. (2026) · doi:10.1093/9780197778654.003.0005
Muroff, J. R. (2026) · doi:10.1093/9780197778654.002.0005
Core Affirmative CBT Content and Clinical Strategies
Pascoe, R. V., Hui, D. J., & Craig, S. L. (2026) · doi:10.1093/9780197778654.003.0003
Craig, D. S. L. (2026) · doi:10.1093/9780197778654.002.0007
Craig, D. S. L. (2026) · doi:10.1093/9780197778654.003.0002
Silber, E., & Moller, A. C. (2026) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-026-00732-1
- Authors
- Wolitzky-Taylor, K., Fenwick, K., Lengnick-Hall, R., Grossman, J., Bearman, S. K., Arch, J., Miranda, J., & Chung, B.
- Affiliations
- University of California, Los Angeles (US)
- University of Southern California (US)
- The University of Texas at Austin (US)
- University of Colorado Boulder (US)
- Corresponding author
- Wolitzky-Taylor, Kate
- ORCID
- Venue
- Community Mental Health Journal
- Published
- 2018-03-09
- Volume
- 54
- Issue
- 7
- Pages
- 899-911
- ISSN
- 0010-3853 (ISSN-L)
- 1573-2789
- PMC
- PMC6129437
- OpenAlex
- W2792149797
- Cited by
- 62
- References
- 57
- Citations by year
- 2026: 19 · 2025: 11 · 2024: 4 · 2023: 11 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 1 · 2018: 5
- FWCI
- 4.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Community Mental Health Journal (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Center for Advancement of Translational Sciences (UL1TR000124)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- exposure-based cognitive behavioral therapy, anxiety disorders, community mental health services, low-income adults, therapist training, treatment funding, treatment access, key informant interviews
- MeSH terms
- Adult, Anxiety Disorders, Community Mental Health Services, Female, Health Services Accessibility, Humans, Implosive Therapy, Interviews as Topic, Male, Middle Aged, Focus Groups
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