University of Wyoming, Department of Psychology, Laramie, WY 82071, USA.
Behav Modif. 2013 Mar;37(2):170-88. doi: 10.1177/0145445512458794. Epub 2012 Sep 25.
Despite the well-established effectiveness of exposure-based cognitive-behavioral therapy (CBT) in the treatment of anxiety disorders, therapists have been slow to adopt CBT into their clinical practice. The present study was conducted to examine the utilization of psychotherapy techniques for anxiety disorders among community practitioners in a rural setting in order to determine the current status of the dissemination of CBT. A sample of 51 licensed psychotherapists from various mental health professions was recruited from online practice listings in the state of Wyoming. Participants completed a survey assessing their use of various psychotherapy techniques in the past 12 months for clients with obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder, and social phobia. Nearly all psychotherapists reported providing CBT, and techniques such as cognitive restructuring, arousal-reduction strategies, and mindfulness were used by the vast majority of respondents. Therapist-assisted exposure was rarely utilized, and providers who delivered exposure therapy often did so alongside other techniques of questionable compatibility with this approach. Non-evidence-based techniques were frequently used, particularly by self-proclaimed anxiety specialists. Our findings highlight the successes and failures of efforts to disseminate exposure-based CBT to community practitioners. Implications for clinical training and practice are discussed.
尽管暴露为基础的认知行为疗法（CBT）在治疗焦虑症方面已得到充分证实，但治疗师在将 CBT 纳入临床实践方面一直进展缓慢。本研究旨在检查农村社区从业者在治疗焦虑症中使用心理治疗技术的情况，以确定 CBT 的传播现状。从怀俄明州的在线实践列表中招募了来自各种心理健康专业的 51 名持照心理治疗师作为样本。参与者完成了一项调查，评估他们在过去 12 个月中为强迫症、创伤后应激障碍、惊恐障碍和社交恐惧症患者使用各种心理治疗技术的情况。几乎所有的心理治疗师都报告提供 CBT，而且绝大多数受访者都使用了认知重构、唤醒减少策略和正念等技术。治疗师辅助暴露很少被使用，提供暴露疗法的提供者经常与其他与该方法不太兼容的技术一起使用。非基于证据的技术经常被使用，特别是自称的焦虑症专家。我们的发现突出了向社区从业者传播基于暴露的 CBT 的成功和失败。讨论了对临床培训和实践的影响。
