Barriers to the use of exposure therapy by psychologists treating anxiety, obsessive‐compuslive disorder, and posttraumatic stress disorder in an Australian sample

Moses, Karen; Gonsalvez, Craig J.; Meade, Tanya

doi:10.1002/jclp.23470

Cited by 3 publications

(2 citation statements)

References 24 publications

(51 reference statements)

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“… Lifespan (unspecified). (Moses et al, 2022 ) Mixed methods Sequential Anxiety-related presentations (combined anxiety disorders, OCD, and PTSD), anxiety disorders, OCD, and PTSD. Lifespan (unspecified).…”

Section: Resultsmentioning

confidence: 99%

Determinants of Exposure Therapy Implementation in Clinical Practice for the Treatment of Anxiety, OCD, and PTSD: A Systematic Review

Racz,

Bialocerkowski,

Calteaux

et al. 2024

Clin Child Fam Psychol Rev

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Exposure therapy (ET) forms a vital part of effective psychotherapy for anxiety-related presentations including anxiety disorders, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD), and is often underutilised in clinical practice. Using the Theoretical Domains Framework (TDF), this systematic review synthesised existing literature on the determinants of ET implementation for anxiety-related presentations and examined differences across presentations and developmental subgroups. Fifty-two eligible studies were assessed using the Mixed Methods Appraisal Tool, with 389 results (99%) mapped onto the TDF. Results suggested that clinicians’ negative beliefs about the consequences of ET were commonly associated with reduced implementation. It also appeared that whilst broad unspecified ET training may be related to improved implementation for anxiety disorders; greater implementation for complex presentations (i.e., PTSD) likely requires more specialised training involving practical components. A subset of domains (e.g., social/professional role and identity) accounted for most results, whilst some remain unexplored (i.e., optimism; reinforcement; memory, attention, and decision processes) or underexplored (i.e., behavioural regulation). Likewise, specific presentations and developmental subgroups (i.e., PTSD and adults) represented a greater proportion of results in the literature than others (i.e., OCD and youth). Future research exploring ET implementation, across specific presentations and developmental subgroups, would benefit from integrating implementation science frameworks to guide the development of targeted, comprehensive strategies to close the research-practice gap of ET for the treatment of anxiety-related presentations.

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Section: Resultsmentioning

confidence: 99%

Determinants of Exposure Therapy Implementation in Clinical Practice for the Treatment of Anxiety, OCD, and PTSD: A Systematic Review

Racz,

Bialocerkowski,

Calteaux

et al. 2024

Clin Child Fam Psychol Rev

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“…Nonetheless, recent work has demonstrated non-inferiority of an internet-based adaptation of WET that incorporates peer specialists instead of clinicians [43]. Addressing the barrier of clinician involvement is particularly important, given reports of clinician hesitation to engage in exposure-based therapies [44]. It has the additional potential benefit of promoting selfagency within patients [45][46][47], which may be particularly relevant for individuals with traumarelated disorders, given the loss of agency that often stems from trauma exposure [46].…”

Section: Discussionmentioning

confidence: 99%

Ecological Momentary Assessments of Trauma-Related Intrusive Memories: Potential Clinical Utility

Pollmann,

Clancy,

Devignes

et al. 2024

Preprint

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As the global prevalence of trauma rises, there is a growing need for accessible and scalable treatments for trauma-related disorders like posttraumatic stress disorder (PTSD). Trauma-related intrusive memories (TR-IMs) are a central PTSD symptom and a target of exposure-based therapies, gold-standard treatments that are effective but resource-intensive. This study examined whether a brief ecological momentary assessment (EMA) protocol assessing the phenomenology of TR-IMs could reduce intrusion symptoms in trauma-exposed adults. Participants (N=131) experiencing at least 2 TR-IMs per week related to a DSM-5 criterion A trauma completed a 2-week EMA protocol during which they reported on TR-IM qualities three times per day, and on posttraumatic stress symptoms at the end of each day. Longitudinal symptom measurements were entered into linear mixed-effects models to test the effect of Time on TR-IMs. Over the 2-week EMA protocol, intrusion symptom severity (cluster B scores) significantly declined (t = -2.78, p = 0.006), while other symptom cluster scores did not significantly change. Follow-up analyses demonstrated that this effect was specific to TR-IMs (t = -4.02, p = 0.0001), and was not moderated by survey completion rate, total PTSD symptom severity, or ongoing treatment. Our findings indicate that implementing an EMA protocol assessing intrusive memories could be an effective trauma intervention. Despite study limitations like its quasi-experimental design and absence of a control group, the specificity of findings to intrusive memories argues against a mere regression to the mean. Overall, an EMA approach could provide a cost-effective and scalable treatment option targeting intrusive memory symptoms.

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Challenges in Grief-Focused Cognitive Behavior Therapy for Prolonged Grief Disorder

Maccallum,

Dawson,

Azevedo

et al. 2023

Cognitive and Behavioral Practice

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Barriers to the use of exposure therapy by psychologists treating anxiety, obsessive‐compuslive disorder, and posttraumatic stress disorder in an Australian sample

Cited by 3 publications

References 24 publications

Determinants of Exposure Therapy Implementation in Clinical Practice for the Treatment of Anxiety, OCD, and PTSD: A Systematic Review

Determinants of Exposure Therapy Implementation in Clinical Practice for the Treatment of Anxiety, OCD, and PTSD: A Systematic Review

Ecological Momentary Assessments of Trauma-Related Intrusive Memories: Potential Clinical Utility

Challenges in Grief-Focused Cognitive Behavior Therapy for Prolonged Grief Disorder

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