Department of Psychology, The University of Sheffield, Sheffield, UK.
Department of Psychology, The University of Sheffield, Sheffield, UK.
Clin Psychol Rev. 2020 Aug;80:101887. doi: 10.1016/j.cpr.2020.101887. Epub 2020 Jul 12.
Despite evidence that exposure therapy is an effective way to treat anxiety, many clinicians fail to implement it appropriately. The current review investigated whether training can improve practicing clinicians' beliefs about and implementation of exposure therapy. A systematic search of four databases (PsycINFO, Medline, Scopus, and ProQuest Dissertations and Theses) identified fifteen studies evaluating the impact of training in exposure therapy. A series of meta-analyses revealed that training had large-sized positive effects on clinicians' knowledge of exposure therapy (d = 1.18), attitudes towards exposure therapy (d = 0.84), and self-efficacy associated with delivering exposure therapy (d = 0.72). There were, however, only medium-sized positive effects on clinicians' intentions to use exposure therapy (d = 0.41) and behavior (d = 0.35). These findings suggest that training can provide clinicians with the knowledge and confidence to use exposure therapy, but might not be sufficient to promote changes in practice. Future research should consider incorporating volitional interventions into training (e.g., if-then planning or implementation intentions), in order to bridge this gap.
尽管有证据表明暴露疗法是一种治疗焦虑症的有效方法，但许多临床医生未能正确地实施它。本综述调查了培训是否可以改善实践临床医生对暴露疗法的信念和实施。通过对四个数据库（PsycINFO、Medline、Scopus 和 ProQuest Dissertations and Theses）进行系统搜索，确定了十五项评估暴露疗法培训影响的研究。一系列元分析表明，培训对临床医生对暴露疗法的知识（d=1.18）、对暴露疗法的态度（d=0.84）以及与提供暴露疗法相关的自我效能（d=0.72）产生了较大的积极影响。然而，对临床医生使用暴露疗法的意图（d=0.41）和行为（d=0.35）只有中等程度的积极影响。这些发现表明，培训可以为临床医生提供使用暴露疗法的知识和信心，但可能不足以促进实践的改变。未来的研究应考虑将意愿干预措施（例如，如果-那么计划或实施意图）纳入培训中，以弥补这一差距。
