Clinical Psychology Unit, Department of Psychology, University of Sheffield, UK.
Clinical Psychology Unit, Department of Psychology, University of Sheffield, UK.
Behav Res Ther. 2016 Jan;76:76-80. doi: 10.1016/j.brat.2015.11.014. Epub 2015 Dec 2.
It is well established that clinicians use exposure therapy far less often than the evidence would suggest is justified. This shortfall has been explained as being at least partly a result of clinicians' beliefs and attitudes about exposure and their trait anxiety. Recent studies have shown that attitudes to exposure therapy for anxiety disorders can be improved through a simple educational approach. This study aimed to determine whether a similar educational approach can improve therapists' attitudes to exposure therapy for the eating disorders, and whether clinician's pre-intervention characteristics influenced the impact of the training. Thirty-four eating disorder clinicians (30 female, four male; mean age = 39.0 years; 85.3% Caucasian) attended a 90-min didactic teaching session on the subject of the use of exposure in treatment of eating disorders. Their attitudes to exposure therapy were measured before and after the workshop, in a within-subject design. The outcome was a substantial improvement in attitudes, with a strong effect size (Cohen's d = 1.68) that was comparable to the outcome of a similar intervention among clinicians working with anxiety disorders. The improvement was not related to clinicians' anxiety levels, but was greater among those whose attitudes were more negative at the outset of the teaching. While this finding needs to be tested for long-term maintenance and its relationship to change in clinical practice, it adds to the evidence that a simple educational intervention is sufficient to result in substantial improvement in clinicians' attitudes to exposure therapy.
临床医生使用暴露疗法的频率远低于证据所表明的合理水平，这一点已得到充分证实。这种不足至少部分可以解释为临床医生对暴露疗法的信念和态度及其特质焦虑。最近的研究表明，通过简单的教育方法可以改善对焦虑症暴露疗法的态度。本研究旨在确定类似的教育方法是否可以改善治疗师对饮食障碍暴露疗法的态度，以及临床医生的干预前特征是否会影响培训的效果。34 名饮食障碍临床医生（30 名女性，4 名男性；平均年龄 39.0 岁；85.3%为白种人）参加了一个 90 分钟的关于在饮食障碍治疗中使用暴露疗法的专题讲座。在干预前和干预后采用被试内设计测量他们对暴露疗法的态度。结果表明，态度有了很大的改善，效果量很强（Cohen's d = 1.68），与焦虑症临床医生接受类似干预的结果相当。这种改善与临床医生的焦虑水平无关，但在教学开始时态度更为消极的临床医生中更为明显。虽然需要对长期维持和与临床实践变化的关系进行测试，但这一发现增加了证据，即简单的教育干预足以使临床医生对暴露疗法的态度得到实质性改善。
