Cited by 2,339Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMemory and Neural MechanismsPsychotherapy Techniques and Applications

The DOI matches its Crossref record; 106 of the 108 references it cites were found in a registry or an index, and 1 are not checked yet.

Maximizing exposure therapy: An inhibitory learning approach

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Abstract

Exposure therapy is an effective approach for treating anxiety disorders, although a substantial number of individuals fail to benefit or experience a return of fear after treatment. Research suggests that anxious individuals show deficits in the mechanisms believed to underlie exposure therapy, such as inhibitory learning. Targeting these processes may help improve the efficacy of exposure-based procedures. Although evidence supports an inhibitory learning model of extinction, there has been little discussion of how to implement this model in clinical practice. The primary aim of this paper is to provide examples to clinicians for how to apply this model to optimize exposure therapy with anxious clients, in ways that distinguish it from a ‘fear habituation’ approach and ‘belief disconfirmation’ approach within standard cognitive-behavior therapy. Exposure optimization strategies include 1) expectancy violation, 2) deepened extinction, 3) occasional reinforced extinction, 4) removal of safety signals, 5) variability, 6) retrieval cues, 7) multiple contexts, and 8) affect labeling. Case studies illustrate methods of applying these techniques with a variety of anxiety disorders, including obsessive-compulsive disorder, posttraumatic stress disorder, social phobia, specific phobia, and panic disorder.

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Crossref · 10.1016/j.brat.2014.04.006

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Metadata

Authors
Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B.
Affiliations
  • University of California, Los Angeles (US)
  • KU Leuven (BE)
Corresponding author
Craske, Michelle G.
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2014-07
Volume
58
Pages
10-23
ISSN
0005-7967 (ISSN-L)
OpenAlex
W2057906075
Cited by
2,339
References
108
Citations by year
2026: 304 · 2025: 247 · 2024: 265 · 2023: 196 · 2022: 233 · 2021: 245 · 2020: 213 · 2019: 175 · 2018: 156 · 2017: 124 · 2016: 107 · 2015: 59 · 2014: 12
FWCI
139.66
Type
journal article
Language
en
Open access
Locations
  • Behaviour Research and Therapy (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Lirias (submittedVersion, other-oa)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institute of Mental Health (R34MH101359, R21MH081299, R01MH065651)
  • National Human Genome Research Institute (T32HG002536)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
exposure therapy, inhibitory learning, extinction learning, anxiety disorders, treatment optimization, expectancy violation, safety signals, retrieval cues, affect labeling, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety disorder, specific phobia, panic disorder
MeSH terms
Adult, Anxiety Disorders, Extinction, Psychological, Female, Humans, Implosive Therapy, Inhibition, Psychological, Learning, Male

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