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操纵进食障碍暴露疗法的理论框架会影响临床医生的治疗偏好。

Manipulating the theoretical framing of exposure therapy for eating disorders impacts clinicians' treatment preferences.

机构信息

Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, 40292, USA.

出版信息

Eat Weight Disord. 2020 Oct;25(5):1205-1212. doi: 10.1007/s40519-019-00751-3. Epub 2019 Jul 17.

Abstract

BACKGROUND

Exposure therapy is the most effective treatment for anxiety and related disorders and its efficacy in the eating disorders is rapidly gaining support. Despite the strong evidence behind exposure therapy, many anxiety disorder providers do not endorse the usage of exposure therapy. Limited research has explored the use of exposure therapy in eating disorder providers, as well as the impact of framing on likelihood to use exposure therapy.

OBJECTIVE

The current study (N = 125 eating disorder providers) manipulated the framing of exposure to feared foods (pizza).

METHODS

We framed the treatment as an exposure, behavioral experiment, or acceptance/mindfulness-based intervention. We also tested attitudes towards exposure therapy in eating disorder providers.

RESULTS

Participants were more likely to endorse willingness to use a treatment framed as a behavioral experiment over exposure and acceptance-based framing. This effect did not vary by degree type, type of provider, years in practice, experience, or training. We also found that providers with more training, specifically in eating disorder exposure, were more likely to use exposure over acceptance-based framed intervention (and vice versa). Finally, we found that eating disorder providers had a somewhat positive view of exposure therapy.

CONCLUSION

Framing of the intervention impacts likelihood that providers will endorse using specific interventions. Therefore, intervention development and dissemination efforts should consider the language around the description of evidence-based treatments. Furthermore, enhanced training and education specifically with eating disorder exposure therapy may enhance the likelihood of providers utilizing exposure therapy. Level I: experimental study.

摘要

背景

暴露疗法是治疗焦虑症和相关障碍最有效的方法,其在饮食障碍中的疗效也迅速得到支持。尽管暴露疗法有强有力的证据支持,但许多焦虑症治疗师并不认可暴露疗法的使用。有限的研究探讨了暴露疗法在饮食障碍治疗师中的使用情况,以及框架对使用暴露疗法的可能性的影响。

目的

本研究(N=125 名饮食障碍治疗师)对暴露于恐惧食物(比萨)的治疗框架进行了操作。

方法

我们将治疗方案分别框定为暴露、行为实验或接纳/正念干预。我们还测试了饮食障碍治疗师对暴露疗法的态度。

结果

与暴露和接纳为基础的框架相比,参与者更倾向于认可将治疗方案框定为行为实验的意愿。这种效果不因治疗师类型、类型、从业年限、经验或培训而有所不同。我们还发现,接受过更多培训的治疗师,特别是在饮食障碍暴露方面,更倾向于使用暴露治疗而不是基于接纳的干预(反之亦然)。最后,我们发现饮食障碍治疗师对暴露疗法有一定的积极看法。

结论

干预的框架会影响治疗师认可使用特定干预措施的可能性。因此,干预措施的开发和传播工作应考虑到描述循证治疗方法的语言。此外,专门针对饮食障碍暴露疗法的强化培训和教育可能会提高治疗师使用暴露疗法的可能性。一级:实验研究。

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