A randomized controlled trial of the judicious use of safety behaviors during exposure therapy

Shannon M. Blakey, Jonathan Stuart Abramowitz, Jennifer L. Buchholz, Sarah C. Jessup, Ryan J. Jacoby, Lillian Reuman, Kimberly Z. Pentel

Research output: Contribution to journalArticle

Abstract

Safety behaviors—actions performed to prevent, escape from, or reduce the severity of perceived threat—are typically eliminated during exposure therapy for clinical anxiety. Yet some experts have called for the strategic and “judicious use” of safety behaviors during exposure to improve treatment acceptability/tolerability without diminishing its efficacy. Empirical findings regarding this debate are mixed and existing work is subject to several methodological limitations. The current randomized controlled trial incorporated longitudinal design and multimethod assessment to compare the efficacy of traditional exposure with the elimination of safety behaviors (E/ESB) and exposure with judiciously used safety behaviors (E/JU). Adults with clinically significant spider fear (N = 60) were randomized to four twice-weekly sessions of E/ESB or E/JU. Self-report and behavioral measures were administered at pretreatment, posttreatment, and 1-month follow-up. Participants exhibited large effects on all measures from pretreatment to posttreatment, with no change from posttreatment to follow-up. There were no significant group differences in treatment outcome or treatment acceptability/tolerability. Exploratory analyses were used to compare behavioral and inhibitory learning processes between conditions. Clinical implications, study limitations, and future directions are discussed in terms of inhibitory learning theory.

LanguageEnglish (US)
Pages28-35
Number of pages8
JournalBehaviour Research and Therapy
Volume112
DOIs
StatePublished - Jan 1 2019

Fingerprint

Implosive Therapy
Randomized Controlled Trials
Safety
Learning
Spiders
Self Report
Fear
Anxiety

Keywords

  • Anxiety
  • Exposure therapy
  • Inhibitory learning
  • Phobia
  • Safety behaviors

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

A randomized controlled trial of the judicious use of safety behaviors during exposure therapy. / Blakey, Shannon M.; Abramowitz, Jonathan Stuart; Buchholz, Jennifer L.; Jessup, Sarah C.; Jacoby, Ryan J.; Reuman, Lillian; Pentel, Kimberly Z.

In: Behaviour Research and Therapy, Vol. 112, 01.01.2019, p. 28-35.

Research output: Contribution to journalArticle

Blakey, Shannon M. ; Abramowitz, Jonathan Stuart ; Buchholz, Jennifer L. ; Jessup, Sarah C. ; Jacoby, Ryan J. ; Reuman, Lillian ; Pentel, Kimberly Z. / A randomized controlled trial of the judicious use of safety behaviors during exposure therapy. In: Behaviour Research and Therapy. 2019 ; Vol. 112. pp. 28-35.
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