Association between therapists’ negative beliefs about exposure therapy and its use in an Australian sample: a brief report

Despite a wealth of research demonstrating the efficacy of exposure therapy for the anxiety and related disorders, research shows that few therapists use this technique in clinical practice. Negative beliefs about exposure therapy have been shown to be the most significant barrier to use or optimal use. A richer and more nuanced understanding of the relationship between negative beliefs and exposure use, and its implications for training and practice, is warranted. This research aimed to identify the specific negative beliefs about exposure held by Australian psychologists, and the association of these beliefs with the use of therapist-assisted and self-guided exposure (i.e. between-session exposure homework) of exposure therapy for anxiety, obsessive-compulsive, and post-traumatic stress disorders. One hundred registered psychologists participated in an online study. Results suggest that the most frequently endorsed negative belief is the need for arousal reduction techniques to tolerate distress associated with exposure therapy. Negative beliefs about exposure were negatively correlated with both therapist-supported and self-guided exposure of exposure therapy across all disorders, though largest correlations were found for therapist-supported techniques. Training implications of these findings are discussed.