When do trauma experts choose exposure therapy for PTSD patients? A controlled study of therapist and patient factors

van Minnen, Agnes; Hendriks, Lotte; Olff, Miranda

doi:10.1016/j.brat.2009.12.003

Cited by 282Posttraumatic Stress Disorder ResearchPsychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

When do trauma experts choose exposure therapy for PTSD patients? A controlled study of therapist and patient factors

van Minnen, Agnes, Hendriks, Lotte, Olff, Miranda·2010·Behaviour Research and Therapy

DOI 10.1016/j.brat.2009.12.003

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Abstract

To investigate when and why therapists opt for or rule out imaginal exposure (IE) for patients with posttraumatic stress disorder (PTSD), 255 trauma experts were randomized to two conditions in which they were presented with four cases in which the patients' comorbidity and treatment preferences were manipulated. The results confirmed IE to be an underutilized approach, with the majority of professionals being undertrained in the technique. As predicted, the patient factors influenced the expert's choice of therapy: in case of a comorbid depression, IE was significantly less preferred than medication. Also, IE was significantly more likely to be offered when patients expressed a preference for trauma-focused treatment. The therapist factors were also found to be importantly related to treatment preferences, with high credibility in the technique being positively related to the therapists' preference for IE. Perceived barriers to IE, such as a fear of symptom exacerbation and dropout, were negatively related to the perceived suitability of the treatment when patients had suffered multiple traumas in childhood. The results are discussed in the light of clinical implications and the need of exposure training for trauma professionals.

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In posttraumatic stress disorder, imaginal exposure is severely underutilised.
“In the field of posttraumatic stress disorder (PTSD), van Minnen, Hendriks and Olff (2010) have demonstrated that imaginal exposure is severely underutilised”
From Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track (2016) · cites this paper as van Minnen, Hendriks and Olff (2010)

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Authors: van Minnen, A., Hendriks, L., & Olff, M.
Affiliations: Radboud University Nijmegen (NL)
Amsterdam UMC Location University of Amsterdam (NL)
ORCID: Hendriks, Lotte
Olff, Miranda
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2010-04
Volume: 48
Issue: 4
Pages: 312-320
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/j.brat.2009.12.003
OpenAlex: W1986710838
Cited by: 282
References: 27
Citations by year: 2026: 9 · 2025: 19 · 2024: 17 · 2023: 18 · 2022: 18 · 2021: 21 · 2020: 24 · 2019: 20 · 2018: 26 · 2017: 15 · 2016: 21 · 2015: 17 · 2014: 13 · 2013: 22 · 2012: 9
FWCI: 7.41
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Behaviour Research and Therapy (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Radboud Repository (Radboud University) (submittedVersion)
Funders: Achmea Stichting Slachtoffer en Samenleving
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: post-traumatic stress disorder, trauma-focused psychotherapy, treatment selection, therapist decision-making, patient treatment preferences, comorbid depression, childhood trauma, therapist credibility, barriers to treatment
MeSH terms: Age Factors, Attitude to Health, Depression, Female, Humans, Implosive Therapy, Male, Middle Aged, Psychotropic Drugs, Sex Characteristics, Stress Disorders, Post-Traumatic, Comorbidity, Multivariate Analysis, Patient Selection, Patient Preference

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When do trauma experts choose exposure therapy for PTSD patients? A controlled study of therapist and patient factors

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