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澳大利亚样本中,心理学家在治疗焦虑症、强迫症和创伤后应激障碍时使用暴露疗法的障碍。

Barriers to the use of exposure therapy by psychologists treating anxiety, obsessive-compuslive disorder, and posttraumatic stress disorder in an Australian sample.

作者信息

Moses Karen, Gonsalvez Craig J, Meade Tanya

机构信息

School of Psychology, Western Sydney University, Penrith, Australia.

Translational Health Research Institute, Western Sydney University, Penrith, Australia.

出版信息

J Clin Psychol. 2023 Apr;79(4):1156-1165. doi: 10.1002/jclp.23470. Epub 2022 Nov 30.


DOI:10.1002/jclp.23470
PMID:36449416
Abstract

BACGROUND: Exposure therapy is a core component of the evidence-based treatment of anxiety, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). Despite this, many clinicians fail to use exposure therapy in clinical practice, with research highlighting a number of potential barriers. Those findings raise serious concerns regarding the effective dissemination and delivery of evidence-based treatments that in turn have a major impact on client care and cost-effectiveness of psychological interventions. AIMS: The present study aims to examine barriers to the use of exposure therapy in the clinical practice of Australian psychologists treating anxiety, OCD and PTSD. METHOD: One hundred registered psychologists, aged between 23 and 71 years and 84% female, participated in this study via online survey. RESULTS: Results suggest that the most common barriers to the use of exposure therapy include lack of confidence, negative beliefs about exposure therapy, insufficient underpinning theoretical knowledge, client-specific barriers, and logistical limitations. CONCLUSIONS: Future research may further examine those barriers and the components of additional training and supervision that can increase the uptake of exposure therapy, particularly in clinical areas where it is a gold standard of practice.

摘要

背景:暴露疗法是基于证据治疗焦虑症、强迫症(OCD)和创伤后应激障碍(PTSD)的核心组成部分。尽管如此,许多临床医生在临床实践中并未使用暴露疗法,研究突出了一些潜在障碍。这些发现引发了对基于证据的治疗方法有效传播和应用的严重担忧,而这反过来又对患者护理和心理干预的成本效益产生重大影响。 目的:本研究旨在探讨澳大利亚治疗焦虑症、强迫症和创伤后应激障碍的心理学家在临床实践中使用暴露疗法的障碍。 方法:100名注册心理学家参与了本研究,年龄在23岁至71岁之间,其中84%为女性,通过在线调查的方式参与。 结果:结果表明,使用暴露疗法最常见的障碍包括缺乏信心、对暴露疗法的负面看法、理论知识基础不足、特定于患者的障碍以及后勤限制。 结论:未来的研究可以进一步探讨这些障碍以及额外培训和监督的组成部分,这些部分可以增加暴露疗法的采用率,特别是在它是实践金标准的临床领域。

相似文献

[1]
Barriers to the use of exposure therapy by psychologists treating anxiety, obsessive-compuslive disorder, and posttraumatic stress disorder in an Australian sample.

J Clin Psychol. 2023-4

[2]
The Struggle of Behavioral Therapists With Exposure: Self-Reported Practicability, Negative Beliefs, and Therapist Distress About Exposure-Based Interventions.

Behav Ther. 2018-8-3

[3]
Utilisation and predictors of use of exposure therapy in the treatment of anxiety, OCD and PTSD in an Australian sample: a preliminary investigation.

BMC Psychol. 2021-7-27

[4]
Dissemination of exposure in the treatment of anxiety disorders and post-traumatic stress disorder among German cognitive behavioural therapists.

Clin Psychol Psychother. 2018-8-17

[5]
[Virtual reality exposure therapy for post-traumatic stress disorders, obsessive-compulsive disorders and anxiety disorders: Indications, added value and limitations].

Encephale. 2020-8

[6]
A randomized clinical trial to assess the efficacy of trial-based cognitive therapy compared to prolonged exposure for post-traumatic stress disorder: preliminary findings.

CNS Spectr. 2021-8

[7]
The Efficacy of Exposure Therapy for Anxiety-Related Disorders and Its Underlying Mechanisms: The Case of OCD and PTSD.

Annu Rev Clin Psychol. 2015-11-11

[8]
Implications of comorbid OCD on PTSD treatment: A case study.

Bull Menninger Clin. 2018

[9]
Effect of Written Exposure Therapy vs Cognitive Processing Therapy on Increasing Treatment Efficiency Among Military Service Members With Posttraumatic Stress Disorder: A Randomized Noninferiority Trial.

JAMA Netw Open. 2022-1-4

[10]
Serious negative consequences associated with exposure and response prevention for obsessive-compulsive disorder: A survey of therapist attitudes and experiences.

Depress Anxiety. 2020-2-12

引用本文的文献

[1]
Supporting Clinicians in Implementing Exposure Therapy for Anxiety and Related Disorders.

Curr Psychiatry Rep. 2025-5-1

[2]
A look in the mirror - body exposure in clinical practice.

J Eat Disord. 2025-4-18

[3]
Determinants of Exposure Therapy Implementation in Clinical Practice for the Treatment of Anxiety, OCD, and PTSD: A Systematic Review.

Clin Child Fam Psychol Rev. 2024-6

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