Mayo Clinic.
Mayo Clinic.
Behav Ther. 2022 Jul;53(4):642-655. doi: 10.1016/j.beth.2022.01.010. Epub 2022 Feb 4.
Increasing the use of exposure by community therapists during the treatment of childhood anxiety disorders is critical to improving the quality of available treatment. The aim of the current study was to investigate whether a brief training in the delivery of an exposure-focused and technology-assisted treatment protocol increased community therapist openness to exposure therapy, use of exposure in treatment, and improvement in patient symptoms. Participants were 17 therapists recruited from a large health system to provide outpatient therapy to 32 youth ages 8-18 (M = 12.13, 78.1% girls) with treatment as usual or with the Anxiety Coach application (AC-app). Consistent with two of three hypotheses, therapists in the AC-app condition increased their openness to, and use of, exposure-however, these changes did not translate into improved therapeutic outcomes. Comparisons to benchmark studies suggest that the community therapists did not implement enough in vivo exposure of sufficient intensity or include parents enough to improve outcome. Results support the ability of exposure-focused treatment protocols to increase community therapists' use of evidence-based treatment and suggest that future efforts should focus on improving the quality, in addition to quantity, of therapist-delivered exposure.
增加社区治疗师在儿童焦虑障碍治疗中使用暴露疗法的频率对于提高现有治疗质量至关重要。本研究旨在探讨在实施暴露为重点和技术辅助治疗方案方面进行简短培训是否会增加社区治疗师对暴露疗法的接受程度、在治疗中使用暴露疗法的频率以及患者症状的改善程度。研究参与者是从一家大型医疗系统招募的 17 名治疗师，他们为 32 名 8-18 岁（M=12.13，78.1%为女孩）的青少年提供门诊治疗，他们接受常规治疗或使用焦虑教练应用程序（AC-app）治疗。与三个假设中的两个一致，接受 AC-app 治疗的治疗师增加了他们对暴露疗法的开放性和使用频率——然而，这些变化并没有转化为治疗效果的改善。与基准研究的比较表明，社区治疗师没有进行足够数量和足够强度的现场暴露治疗，也没有让家长充分参与治疗，从而无法改善治疗效果。研究结果支持暴露为重点的治疗方案能够增加社区治疗师对循证治疗的使用，并表明未来的努力应侧重于提高治疗师提供的暴露治疗的质量，而不仅仅是数量。
