Assessing therapist reservations about exposure therapy for anxiety disorders: the therapist beliefs about exposure scale

Deacon, Brett J.; Farrell, Nicholas R.; Kemp, Joshua J.; Dixon, Laura J.; Sy, Jennifer T.; Zhang, Annie R.; McGrath, Patrick B.

doi:10.1016/j.janxdis.2013.04.006

Cited by 250Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and ApplicationsPsychological Treatments and Assessments

Assessing therapist reservations about exposure therapy for anxiety disorders: the therapist beliefs about exposure scale

Deacon, Brett J., Farrell, Nicholas R., Kemp, Joshua J., Dixon, Laura J., Sy, Jennifer T., Zhang, Annie R., McGrath, Patrick B.·2013·Journal of Anxiety Disorders

DOI 10.1016/j.janxdis.2013.04.006

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Abstract

Exposure therapy is underutilized in the treatment of pathological anxiety and is often delivered in a suboptimal manner. Negative beliefs about exposure appear common among therapists and may pose a barrier to its dissemination. To permit reliable and valid assessment of such beliefs, we constructed the 21-item Therapist Beliefs about Exposure Scale (TBES) and examined its reliability and validity in three samples of practicing clinicians. The TBES demonstrated a clear single-factor structure, excellent internal consistency (αs=.90-.96), and exceptionally high six-month test-retest reliability (r=.89). Negative beliefs about exposure therapy were associated with therapist demographic characteristics, negative reactions to a series of exposure therapy case vignettes, and the cautious delivery of exposure therapy in the treatment of a hypothetical client with obsessive-compulsive disorder. Lastly, TBES scores decreased markedly following a didactic workshop on exposure therapy. The present findings support the reliability and validity of the TBES.

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Negative beliefs about exposure therapy may become more positive through training or workshops.
“negative beliefs about exposure therapy may become more positive through training or workshops (Deacon et al., 2013; Fang et al., 2019)”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013
Simple educational interventions can enhance implementation and use of exposure therapy.
“To address and improve the negative perception of exposure therapy among practitioners, extensive research has shown that even simple educational interventions can enhance its implementation and use [6].”
From Exploring Predictors of Counselors’ Acceptance of Virtual Reality Exposure Therapy With Resistance and Job Contexts as Moderators: Cross-Sectional Mixed Methods Study (2025) · cites this paper as [6]
Negative beliefs about exposure therapy in therapists may partly explain the underutilization of exposure therapy.
“Negative beliefs about exposure therapy in therapists may partly explain this.”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013
Even limited endorsement of negative beliefs about exposure therapy is associated with less adequate delivery of exposure therapy and with more negative therapist opinions about exposure therapy.
“Even limited endorsement of such negative beliefs is associated with less adequate delivery of exposure therapy and with more negative therapist opinions about exposure therapy (Deacon et al., 2013).”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013
Differences in the composition of the therapist samples may explain the smaller effect size in the current study compared to Deacon et al. (2013) and Fang et al. (2019).
“Differences in the composition of the therapist samples may explain the fact that our effect, while statistically significant, was considerably smaller ( dz =.51) than the effects found by Deacon et al. (2013) ( d =1.50) and Fang et al. (2019) ( d =1.07).”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013

Changes in therapist beliefs about exposure were previously observed in Chinese (Fang et al., 2019) and American (Deacon et al., 2013; Farrell et al., 2016) samples of therapists from different psychotherapeutic backgrounds.
“Changes in therapist beliefs about exposure were previously observed in Chinese (Fang et al., 2019) and American (Deacon et al., 2013; Farrell et al., 2016) samples of therapists from different psychotherapeutic backgrounds.”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013
The TBES showed excellent internal consistency (α=.95), good 6-month test-retest reliability (r=.89), and good construct validity.
“The TBES showed excellent internal consistency ( a = .95), good 6-month test-retest reliability ( r = .89), and good construct validity (Deacon et al., 2013).”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013
The effect of training on beliefs about exposure therapy was smaller than the effects found by Deacon et al. (2013) (d=1.50) and Fang et al. (2019) (d=1.07).
“Differences in the composition of the therapist samples may explain the fact that our effect, while statistically significant, was considerably smaller ( dz =.51) than the effects found by Deacon et al. (2013) ( d =1.50) and Fang et al. (2019) ( d =1.07).”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013
Prior studies show conflicting results regarding the relationship between anxiety sensitivity and therapist beliefs about exposure therapy.
“Previous studies showed conflicting results regarding the relationship between anxiety sensitivity and therapist beliefs about exposure therapy (Fang et al., 2019; Deacon et al., 2013).”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013
Higher TBES scores are associated with less competent delivery of exposure.
“Deacon et al. (2013), who observed that higher TBES scores were associated with less competent delivery of exposure.”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013
The current sample of mainly cognitive behavioral therapists had lower TBES scores at pretest (M=20.96) than the Deacon et al. (2013; M=33.10) and Fang et al. (2019; M=42.79) studies, and there may have been less room for further improvement.
“Our sample of mainly cognitive behavioral therapists had lower TBES scores at pretest ( M =20.96) than the Deacon et al. (2013; M =33.10) and Fang et al. (2019; M =42.79) studies and there may simply have been less room for further improvement.”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013
Only 65.0% of Deacon et al. (2013) sample reported having a behavioral therapeutic orientation, compared to 88.9% of the current sample.
“only 65.0% of Deacon et al. (2013) sample reported having a behavioral therapeutic orientation (compared to 88.9% of our sample).”
From EFFECT OF TRAINING ON BELIEFS ABOUT EXPOSURE THERAPY IN EXPERIENCED THERAPISTS (2023) · cites this paper as Deacon et al., 2013

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Boswell, J. F., Anderson, L. M., Oswald, J. M., Reilly, E. E., Gorrell, S., & Anderson, D. A. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.02.004 · Cited by 56 · see citing works
Virtual reality exposure therapy for fear of heights: clinicians’ attitudes become more positive after trying VRET
Rimer, E., Husby, L. V., & Solem, S. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.671871 · Cited by 54 · see citing works
On the use of exposure therapy in the treatment of anxiety disorders: a survey among cognitive behavioural therapists in the Netherlands
Sars, D., & van Minnen, A. (2015) · BMC Psychology · doi:10.1186/s40359-015-0083-2 · Cited by 52 · see citing works
A meta-analysis of the effects of training clinicians in exposure therapy on knowledge, attitudes, intentions, and behavior
Trivasse, H., Webb, T. L., & Waller, G. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101887 · Cited by 51 · see citing works
A Meta-Analysis of d-Cycloserine in Exposure-Based Treatment
Mcguire, J. F., Wu, M. S., Piacentini, J. C., McCracken, J. T., & Storch, E. A. (2016) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.15r10334 · Cited by 50 · see citing works
Bringing virtual reality from clinical trials to clinical practice for the treatment of eating disorders: An example using virtual reality cue exposure therapy
Brown, T., Nauman Vogel, E., Adler, S., Bohon, C., Bullock, K., Nameth, K., Riva, G., Safer, D. L., & Runfola, C. D. (2020) · Journal of Medical Internet Research · doi:10.2196/16386 · Cited by 49 · see citing works
Treating Social Anxiety in an Era of Social Distancing: Adapting Exposure Therapy for Youth During COVID-19
Khan, A. N., Bilek, E. L., Tomlinson, R. C., & Becker‐Haimes, E. M. (2021) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2020.12.002 · Cited by 49 · see citing works
Serious negative consequences associated with exposure and response prevention for obsessive-compulsive disorder: A survey of therapist attitudes and experiences
Schneider, S. C., Knott, L., Cepeda, S. L., Hana, L. M., McIngvale, E., Goodman, W. K., & Storch, E. A. (2020) · Depression and Anxiety · doi:10.1002/da.23000 · Cited by 48 · see citing works
COVID-19 and OCD: Potential impact of exposure and response prevention therapy
Sheu, J. C., McKay, D., & Storch, E. A. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102314 · Cited by 48 · see citing works
Correlates of therapist drift in psychological practice: A systematic review of therapist characteristics
Speers, A. J. H., Bhullar, N., Cosh, S., & Wootton, B. M. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102132 · Cited by 48 · see citing works
Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders Using Internet-Based Technologies
Kobak, K. A., Wolitzky-Taylor, K. B., Craske, M. G., & Rose, R. D. (2016) · Cognitive Therapy and Research · doi:10.1007/s10608-016-9819-4 · Cited by 47 · see citing works
The role of therapist experiential avoidance in predicting therapist preference for exposure treatment for OCD
Scherr, S. R., Herbert, J. D., & Forman, E. M. (2015) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2014.12.002 · Cited by 44 · see citing works
Exposition aus Sicht niedergelassener Verhaltenstherapeutinnen und Verhaltenstherapeuten: Anwendung und systemische Barrieren
Pittig, A., & Hoyer, J. (2017) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000441 · Cited by 43 · see citing works
Increasing Availability of Exposure Therapy Through Intensive Group Treatment for Childhood Anxiety and OCD
Whiteside, S. P. H., Dammann, J. E., Tiede, M. S., Biggs, B. K., & Jensen, A. H. (2017) · Behavior Modification · doi:10.1177/0145445517730831 · Cited by 43 · see citing works
Benchmarking Treatment Adherence and Therapist Competence in Individual Cognitive-Behavioral Treatment for Youth Anxiety Disorders
McLeod, B. D., Southam‐Gerow, M. A., Jensen‐Doss, A., Hogue, A., Kendall, P. C., & Weisz, J. R. (2017) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2017.1381914 · Cited by 43 · see citing works
“It’s Worth It in the End”: Veterans’ Experiences in Prolonged Exposure and Cognitive Processing Therapy
Hundt, N. E., Fletcher, T. L., Arney, J., & Stanley, M. A. (2016) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2016.02.003 · Cited by 40 · see citing works
Clinician-reported barriers to using exposure with response prevention in the treatment of paediatric obsessive-compulsive disorder
Keleher, J., Jassi, A. D., & Krebs, G. (2019) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2019.100498 · Cited by 40 · see citing works
Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder
Spencer, S. D., Stiede, J. T., Wiese, A. D., Goodman, W. K., Guzick, A. G., & Storch, E. A. (2022) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2022.10.004 · Cited by 40 · see citing works
Determinants of Exposure Therapy Implementation in Clinical Practice for the Treatment of Anxiety, OCD, and PTSD: A Systematic Review
Racz, J. I., Bialocerkowski, A., Calteaux, I., & Farrell, L. (2024) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-024-00478-3 · Cited by 33 · see citing works
Process Factors Associated with Improved Outcomes in CBT for Anxious Youth: Therapeutic Content, Alliance, and Therapist Actions
Crawford, E. A., Frank, H. E., Palitz, S. A., Davis, J. P., & Kendall, P. C. (2017) · Cognitive Therapy and Research · doi:10.1007/s10608-017-9864-7 · Cited by 37 · see citing works
Who is stressed? A pilot study of salivary cortisol and alpha-amylase concentrations in agoraphobic patients and their novice therapists undergoing in vivo exposure
Schumacher, S., Gaudlitz, K., Plag, J., Miller, R. E., Kirschbaum, C., Fehm, L., Fydrich, T., & Ströhle, A. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.07.016 · Cited by 37 · see citing works
Internet-Delivered Cognitive Behavioral Therapy for Children With Pain-Related Functional Gastrointestinal Disorders: Feasibility Study
Lalouni, M., Ljótsson, B., Bonnert, M., Hedman‐Lagerlöf, E., Högström, J., Serlachius, E., & Olén, O. (2017) · JMIR Mental Health · doi:10.2196/mental.7985 · Cited by 36 · see citing works
Evidence-based implementation practices applied to the intensive treatment of eating disorders: summary of research and illustration of principles using a case example
Thompson-Brenner, H., Brooks, G. E., Boswell, J. F., Espel-Huynh, H., Dore, R., Franklin, D. R., Gonçalves, A., Smith, M., Ortiz, S., Ice, S., et al. (2018) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12221 · Cited by 35 · see citing works
Cue Exposure Therapy for Alcohol Use Disorders: What Can Be Learned from Exposure Therapy for Anxiety Disorders?
Byrne, S., Haber, P., Baillie, A., Giannopolous, V., & Morley, K. C. (2019) · Substance Use & Misuse · doi:10.1080/10826084.2019.1618328 · Cited by 35 · see citing works
Facets of clinicians' anxiety and the delivery of cognitive behavioral therapy
Levita, L., Salas Duhne, P. G., Girling, C., & Waller, G. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.12.015 · Cited by 34 · see citing works
“…of CBT elements is important for two primary reasons – the identification of clinicians who will need additional support to deliver specific elements of the therapy, and the planning of interventions to support those clinicians (e.g., Deacon et al., 2013; Farrell, Deacon, Dixon & Lickel, 2013).”
Background
The effects of a prolonged exposure workshop with and without consultation on provider and patient outcomes: a randomized implementation trial
Foa, E. B., McLean, C. P., Brown, L. A., Zang, Y., Rosenfield, D., Zandberg, L. J., Ealey, W., Hanson, B. S., Hunter, L. R., Lillard, I. J., et al. (2020) · Implementation Science · doi:10.1186/s13012-020-01014-x · Cited by 33 · see citing works
Effectiveness, User Engagement and Experience, and Safety of a Mobile App (Lumi Nova) Delivering Exposure-Based Cognitive Behavioral Therapy Strategies to Manage Anxiety in Children via Immersive Gaming Technology: Preliminary Evaluation Study
Lockwood, J., Williams, L., Martin, J. L., Rathee, M., & Hill, C. (2022) · JMIR Mental Health · doi:10.2196/29008 · Cited by 32 · see citing works
Stakeholder Perceptions of the Barriers to Receiving and Delivering Exposure-Based Cognitive Behavioral Therapy for Anxiety Disorders in Adult Community Mental Health Settings
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
“2000, 2010) and therapist experiences, beliefs about, and training in CBT and exposure (Weissman et al. 2006; Herschell et al. 2010; Deacon et al. 2013; Farrell et al. 2013), we hypothesized that patients would find exposure-based CBT acceptable, but that providers would find it less so, or believe they lacked the ski…”
Background
Training with tarantulas: A randomized feasibility and acceptability study using experiential learning to enhance exposure therapy training
Frank, H. E., Becker‐Haimes, E. M., Rifkin, L. S., Norris, L. A., Ollendick, T. H., Olino, T. M., Kratz, H. E., Beidas, R. S., & Kendall, P. C. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102308 · Cited by 30 · see citing works
The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders
Wu, M. S., Caporino, N. E., Peris, T. S., Pérez, J., Thamrin, H., Albano, A. M., Kendall, P. C., Walkup, J. T., Birmaher, B. B., Compton, S. N., et al. (2019) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-019-00574-x · Cited by 29 · see citing works
Closing the Gap for Children with OCD: A Staged-Care Model of Cognitive Behavioural Therapy with Exposure and Response Prevention
Farrell, L. J., Waters, A. M., Storch, E. A., Simcock, G. P., Perkes, I. E., Grisham, J. R., Dyason, K. M., & Ollendick, T. H. (2023) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-023-00439-2 · Cited by 28 · see citing works
Psychological therapy using virtual reality for treatment of driving phobia: a systematic review
Elphinston, R. A., Vaezipour, A., Fowler, J. A., Russell, T. G., & Sterling, M. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2022.2069293 · Cited by 27 · see citing works
Identifying the organizational innovation-specific capacity needed for exposure therapy
Becker‐Haimes, E. M., Byeon, Y. V., Frank, H. E., Williams, N. J., Kratz, H. E., & Beidas, R. S. (2020) · Depression and Anxiety · doi:10.1002/da.23035 · Cited by 27 · see citing works
Obsessive–Compulsive Disorder in Children and Adolescents
Stiede, J. T., Spencer, S. D., Onyeka, O. “., Mangen, K. H., Church, M. J., Goodman, W. K., & Storch, E. A. (2023) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-080822-043910 · Cited by 27 · see citing works
School Counselor Perspectives on Implementing a Modular Treatment for Youth
Corteselli, K. A., Hollinsaid, N. L., Harmon, S. L., Bonadio, F. T., Westine, M., Weisz, J. R., & Price, M. A. (2020) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2020.1765434 · Cited by 27 · see citing works
The bumpy road of trauma‐focused treatment: Posttraumatic stress disorder symptom exacerbation in people with psychosis
Burger, S. R., Hardy, A., van der Linden, T., van Zelst, C., de Bont, P. A. J. M., van der Vleugel, B. M., Staring, A. B. P., de Roos, C., de Jongh, A., Marcelis, M. C., et al. (2023) · Journal of Traumatic Stress · doi:10.1002/jts.22907 · Cited by 27 · see citing works
Omega-3 fatty acids and anxiety: A systematic review of the possible mechanisms at play
Polokowski, A. R., Shakil, H., Carmichael, C. L., & Reigada, L. C. (2018) · Nutritional Neuroscience · doi:10.1080/1028415x.2018.1525092 · Cited by 26 · see citing works
Therapists’ characteristics associated with the (non-)use of exposure in the treatment of anxiety disorders in youth: A survey among Dutch-speaking mental health practitioners
de Jong, R., Lommen, M. J. J., van Hout, W. J. P. J., de Jong, P. J., & Nauta, M. H. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102230 · Cited by 25 · see citing works
Therapists' and patients' stress responses during graduated versus flooding in vivo exposure in the treatment of specific phobia: A preliminary observational study.
Schumacher, S., Miller, R., Fehm, L., Kirschbaum, C., Fydrich, T., & Ströhle, A. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.10.020 · Cited by 25 · see citing works
Exposure-Based Strategies in Treating Eating Disorders, the Use of
Becker, C. B., & Waller, G. (2017) · Springer eBooks · doi:10.1007/978-981-287-104-6_168 · Cited by 24 · see citing works
Impact of education on clinicians' attitudes to exposure therapy for eating disorders
Waller, G., D'Souza Walsh, K., & Wright, C. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.11.014 · Cited by 23 · see citing works
Therapist factors associated with intent to use exposure therapy: a systematic review and meta-analysis
Langthorne, D., Beard, J., & Waller, G. (2023) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2023.2191824 · Cited by 23 · see citing works
The Behavior Therapy Training Institute for OCD: A preliminary report
Reese, H. E., Pollard, C. A., Szymanski, J., Berman, N. C., Crowe, K., Rosenfield, E., & Wilhelm, S. (2015) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2015.12.005 · Cited by 22 · see citing works
Examining How CBT Interventions for Anxious Youth Are Delivered Across Settings
Cox, J. R., McLeod, B. D., Jensen‐Doss, A., Ali, A., Southam‐Gerow, M. A., Kendall, P. C., & Weisz, J. R. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.11.008 · Cited by 20 · see citing works
Clinician Maladaptive Anxious Avoidance in the Context of Implementation of Evidence-Based Interventions: A Commentary
Becker‐Haimes, E. M., Klein, C. C., Frank, H. E., Oquendo, M. A., Jager‐Hyman, S., Brown, G. K., Brady, M., & Barnett, M. L. (2022) · Frontiers in Health Services · doi:10.3389/frhs.2022.833214 · Cited by 20 · see citing works
Barriers to the use of exposure therapy by psychologists treating anxiety, obsessive-compuslive disorder, and posttraumatic stress disorder in an Australian sample.
Moses, K., Gonsalvez, C., & Meade, T. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23470 · Cited by 20 · see citing works
A Randomized Controlled Trial of OC-Go for Childhood Obsessive–Compulsive Disorder: Augmenting Homework Compliance in Exposure With Response Prevention Treatment
Tuerk, P. W., Mcguire, J. F., & Piacentini, J. C. (2023) · Behavior Therapy · doi:10.1016/j.beth.2023.07.005 · Cited by 19 · see citing works
Dissemination of exposure in the treatment of anxiety disorders and post‐traumatic stress disorder among German cognitive behavioural therapists
Schumacher, S., Weiss, D., & Knaevelsrud, C. (2018) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2320 · Cited by 19 · see citing works
Suicidal ideation, self-injury, aggressive behavior and substance use during intensive trauma-focused treatment with exposure-based components in adolescent and young adult PTSD patients
Fischer, A., Rosner, R., Renneberg, B., & Steil, R. (2022) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-021-00172-8 · Cited by 18 · see citing works
Exposure Therapy Beliefs and Utilization for Treatment of PTSD: A Survey of Licensed Mental Health Providers
Kline, A. C., Klein, A. B., Bowling, A. R., & Feeny, N. C. (2021) · Behavior Therapy · doi:10.1016/j.beth.2021.01.002 · Cited by 18 · see citing works
Patient Perceptions of In Vivo Versus Virtual Reality Exposures for the Treatment of Anxiety Disorders: Cross-Sectional Survey Study
Lévy, A., Nittas, V., & Wray, T. B. (2023) · JMIR Formative Research · doi:10.2196/47443 · Cited by 18 · see citing works
“Generalized unsafety” as fear inhibition to safety signals in adults with and without childhood trauma
Huskey, A., Taylor, D. J., & Friedman, B. H. (2022) · Developmental Psychobiology · doi:10.1002/dev.22242 · Cited by 18 · see citing works
Therapist stuck points during training in cognitive processing therapy: Changes over time and associations with training outcomes.
LoSavio, S. T., Dillon, K. H., Murphy, R. A., & Resick, P. A. (2019) · Professional Psychology Research and Practice · doi:10.1037/pro0000224 · Cited by 17 · see citing works
Improving Delivery Behaviors During Exposure for Pediatric OCD: A Multiple Baseline Training Trial With Community Therapists
Benito, K., Herren, J. A., Freeman, J. B., Garcia, A. M., Block, P., Cantor, E., Chorpita, B. F., Wellen, B. C. M., Stewart, E., Georgiadis, C., et al. (2020) · Behavior Therapy · doi:10.1016/j.beth.2020.10.003 · Cited by 17 · see citing works
Can psychological interventions prevent or reduce risk for perinatal anxiety disorders? A systematic review and meta-analysis
Zimmermann, M., Julce, C., Sarkar, P. R., McNicholas, E., Xu, W., Carr, C., Boudreaux, E. D., Lemon, S. C., & Byatt, N. (2023) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2023.08.005 · Cited by 17 · see citing works
Exposure to exposure: A protocol for leveraging exposure principles during training to address therapist-level barriers to exposure implementation
Kemp, J. J., Benito, K., Herren, J. A., Brown, Z. A., Frank, H. E., & Freeman, J. B. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1096259 · Cited by 17 · see citing works
Self-citation
Things that make you go Hmm: Myths and misconceptions within cognitive-behavioral treatment of obsessive-compulsive disorder
Spencer, S. D., Stiede, J. T., Wiese, A. D., Guzick, A. G., Cervin, M., McKay, D., & Storch, E. A. (2023) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2023.100805 · Cited by 15 · see citing works
Therapist beliefs about exposure therapy implementation
Meyer, J. M., Kelly, P. J., & Deacon, B. J. (2020) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x20000112 · Cited by 15 · see citing works
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Does CBT for anxiety-related disorders alter suicidal ideation? Findings from a naturalistic sample
Brown, L. A., Gallagher, T., Petersen, J., Benhamou, K., Foa, E. B., & Asnaani, A. (2018) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2018.08.001 · Cited by 14 · see citing works
Using Technology to Promote Therapist Use of Exposure Therapy for Childhood Anxiety Disorders: A Randomized Pilot Study
Whiteside, S. P. H., Biggs, B. K., Ollendick, T. H., Dammann, J. E., Tiede, M. S., Hofschulte, D. R., Reneson-Feeder, S. T., Cunningham, M. L., Sawchuk, N. R., Geske, J. R., et al. (2022) · Behavior Therapy · doi:10.1016/j.beth.2022.01.010 · Cited by 14 · see citing works
Maladaptive therapist schemas in CBT practice, training and supervision: A scoping review
Roscoe, J., & Taylor, J. (2022) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2802 · Cited by 14 · see citing works
Clinicians’ perspectives on retraumatisation during trauma-focused interventions for post-traumatic stress disorder: A survey of UK mental health professionals
Purnell, L. R., Chiu, K., Bhutani, G., Grey, N., El‐Leithy, S., & Meiser‐Stedman, R. (2024) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2024.102913 · Cited by 14 · see citing works
Daring to process the trauma: using a web-based training to reduce psychotherapists’ fears and reservations around implementing trauma-focused therapy
Sansen, L. M., Saupe, L. B., Steidl, A., Fegert, J. M., Hoffmann, U., & Neuner, F. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1696590 · Cited by 14 · see citing works
The Progressive Cascading Model Improves Exposure Delivery in Trainee Therapists Learning Exposure Therapy for Obsessive-Compulsive Disorder
Reid, A. M., Guzick, A., Balkhi, A. M., McBride, M. K., Geffken, G., & Mcnamara, J. P. H. (2017) · Training and Education in Professional Psychology · doi:10.1037/tep0000159 · Cited by 15 · see citing works
Preliminary study of efficacy and safety of self-administered virtual exposure therapy for social anxiety disorder vs. Cognitive-behavioral therapy
Stefaniak, I., Hanusz, K., Mierzejewski, P., Bieńkowski, P., Parnowski, T., & Murawiec, S. (2022) · Brain Sciences · doi:10.3390/brainsci12091236 · Cited by 12 · see citing works
The Impact of Australian Psychologists’ Education, Beliefs, Theoretical Understanding, and Attachment on the Use and Implementation of Exposure Therapy
Rowe, C., & Kangas, M. (2020) · Behaviour Change · doi:10.1017/bec.2020.9 · Cited by 12 · see citing works
Readiness of Allied Professionals to Join the Mental Health Workforce: A Qualitative Evaluation of Trained Lay Trauma Counsellors’ Experiences When Refugee Youth Disclose Suicidal Ideation
Gupta, S. L., Wijk, K., Warner, G., & Sarkadi, A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18041486 · Cited by 12 · see citing works
Clinician-Reported Determinants of Evidence-Based Practice Use in Private Practice Mental Health
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Disseminating Cognitive-Behavioral Therapy for obsessive compulsive disorder: Comparing in person vs. online training modalities
Jacoby, R. J., Berman, N. C., Reese, H. E., Shin, J. Y., Sprich, S. E., Szymanski, J., Pollard, C. A., & Wilhelm, S. (2019) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2019.100485 · Cited by 12 · see citing works
The progress cascading model: A scalable model for teaching and mentoring graduate trainees in exposure therapy
Balkhi, A. M., Reid, A. M., Guzick, A. G., Geffken, G. R., & McNamara, J. P. H. (2016) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2016.02.005 · Cited by 12 · see citing works
Feasibility and Acceptability of a Toolkit to Facilitate Clinician Use of Exposure Therapy for Youth
Becker‐Haimes, E. M., Franklin, M. E., Bodie, J., & Beidas, R. S. (2017) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2017.1383867 · Cited by 12 · see citing works
Dissemination of empirically supported treatments for anxiety disorders: Introduction to the special issue
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Self-citation
Utilisation and predictors of use of exposure therapy in the treatment of anxiety, OCD and PTSD in an Australian sample: a preliminary investigation
Moses, K., Gonsalvez, C. J., & Meade, T. (2021) · BMC Psychology · doi:10.1186/s40359-021-00613-7 · Cited by 11 · see citing works
The impact of implementation climate on community mental health clinicians’ attitudes toward exposure: An evaluation of the effects of training and consultation
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
Psychotherapists’ reports of technique use when treating anxiety disorders: factors associated with specific technique use
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Überzeugungen von Therapeuten in Bezug auf Exposition: Entwicklung einer deutschen Version der Therapist Beliefs about Exposure Scale
Becker, S., Witthöft, M., & Klan, T. (2018) · Verhaltenstherapie · doi:10.1159/000479890 · Cited by 3 · see citing works
The German Adaptation of the Therapist Beliefs about Exposure Scale: a Validation Study among Licensed Cognitive Behavioural Therapists in Germany
Schumacher, S., Schopka, N. M., Heinrich, M., & Knaevelsrud, C. (2018) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465818000371 · Cited by 6 · see citing works
Evaluating the Relationship Between Therapist Negative Beliefs About Exposure Therapy and Delivery Behavior
Kemp, J., Norris, L. A., Fenley, A., Kidd, A., Mamaril, E., Herren, J. A., Freeman, J., & Benito, K. (2024) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2024.06.003 · Cited by 2 · see citing works
Self-citation
Association between therapists’ negative beliefs about exposure therapy and its use in an Australian sample: a brief report
Moses, K., Gonsalvez, C. J., Kurt, P., & Meade, T. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2025.2578746 · Cited by 1 · see citing works
Translated article: Überzeugungen von Therapeuten in Bezug auf Exposition: Entwicklung einer deutschen Version der Therapist Beliefs about Exposure Scale
S., B., M., W., & Klan, T. (2018) · Figshare · doi:10.6084/m9.figshare.6797354

Authors: Deacon, B. J., Farrell, N. R., Kemp, J. J., Dixon, L. J., Sy, J. T., Zhang, A. R., & McGrath, P. B.
Affiliations: University of Wyoming (US)
Alexian Brothers Health System (US)
ORCID: Deacon, Brett J.
Farrell, Nicholas R.
Kemp, Joshua J.
Dixon, Laura J.
Sy, Jennifer T.
McGrath, Patrick B.
Venue: Journal of Anxiety Disorders
Publisher: Elsevier BV
Published: 2013-12
Volume: 27
Issue: 8
Pages: 772-780
ISSN: 0887-6185 (ISSN-L)
DOI: 10.1016/j.janxdis.2013.04.006
OpenAlex: W2166084011
Cited by: 248
References: 44
Citations by year: 2026: 17 · 2025: 30 · 2024: 18 · 2023: 19 · 2022: 30 · 2021: 20 · 2020: 22 · 2019: 22 · 2018: 16 · 2017: 20 · 2016: 10 · 2015: 13 · 2014: 6 · 2013: 5
FWCI: 15.32
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: Journal of Anxiety Disorders (publishedVersion)
PubMed (publishedVersion)
Research Online (University of Wollongong) (submittedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords: exposure therapy, therapist beliefs, anxiety disorders, obsessive-compulsive disorder, treatment dissemination, therapist attitudes, scale development, test-retest reliability, factor structure
MeSH terms: Adult, Anxiety Disorders, Attitude of Health Personnel, Cross-Sectional Studies, Female, Humans, Implosive Therapy, Male, Middle Aged, Brief Psychiatric Rating Scale, Personality Inventory, Professional Practice, Psychiatric Status Rating Scales, Sensitivity and Specificity, Reproducibility of Results, Principal Component Analysis

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Assessing therapist reservations about exposure therapy for anxiety disorders: the therapist beliefs about exposure scale

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