Using values interventions to improve exposure therapy engagement in specific phobias.

Journal of Psychotherapy Integration, Vol 34(1), Mar 2024, 75-87; doi:10.1037/int0000320Exposure therapy is the gold standard for treating specific phobias (SPs). However, most individuals never seek treatment, refuse treatment, or prematurely drop out. This integrative review brings together literature from the fields of SPs, other anxiety and related disorders, exposure therapy, and acceptance and commitment therapy (ACT) to identify reasons for limited engagement and to provide a potential solution. Operant processes involved in maintaining SPs are first discussed as drivers of limited willingness to engage with treatment. Individuals with SPs are more motivated to avoid contact with phobic stimuli—a requirement of exposure therapy—regardless of possible approach benefits. Following, a novel solution based on ACT values components, which directly targets the operant processes involved in SPs, is proposed. Values interventions aim to clarify what is important in one’s life and promote behavior consistent with stated values even in the presence of difficult thoughts and emotions. Such work can provide meaning and reinforcement for approaching phobic stimuli. Therefore, values interventions have the potential to enhance willingness to pursue and persist in exposure, enabling individuals to augment treatment benefits and reduce costs. To guide this endeavor, recommendations to clinicians and researchers are presented. Clinical vignettes from real patients are also provid...
Source: Journal of Psychotherapy Integration - Category: Psychiatry & Psychology Source Type: research