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Assessing therapist reservations about exposure therapy for anxiety disorders: The Therapist Beliefs about Exposure Scale
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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In the citing paper
“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
In the citing paper
“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].”
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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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Self-citation
Metadata
- 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
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2013-12
- Volume
- 27
- Issue
- 8
- Pages
- 772-780
- ISSN
- 0887-6185 (ISSN-L)
- 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
- 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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