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Psychotherapists’ reports of technique use when treating anxiety disorders: factors associated with specific technique use

Parker, Zachary J and Waller, Glenn (2019) Psychotherapists’ reports of technique use when treating anxiety disorders: factors associated with specific technique use. Cognitive Behaviour Therapist, 12. ISSN 1754-470X

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Abstract

Cognitive behavioural therapy (CBT) is the most efficacious and effective psychological intervention for treating anxiety disorders. Behavioural techniques, in particular exposure-based techniques, are fundamental to positive outcomes. However, research suggests that these techniques are either not used or are under-used when treating anxiety disorders. This study assesses therapists’ reported use of CBT techniques in the treatment of anxiety disorders, and explores which therapist variables influence technique use. A total of 173 CBT therapists completed measures on their demographics, routine therapy practices in treating anxiety disorders, and internal states (e.g. self-esteem). These data were analysed to see how often therapists employed particular techniques and the correlates of the use of those techniques. Behavioural techniques (e.g. exposure) were the least utilized set of core CBT skills, being used less often than non-CBT techniques. The under-utilization of these key techniques was associated with greater levels of increased inhibitory anxiety amongst therapists. Supervision and therapists’ self-esteem were both positively associated with the use of non-CBT techniques. While this study established what CBT therapists purport to use in routine practice with anxious populations, further research is needed to assess the association between adherence (or lack thereof) and client outcomes, and the factors that drive non-adherence. Key learning aims As a result of reading this paper, the reader should: (1)Learn about what psychotherapists report as occurring in routine care for individuals with anxiety and related disorders. (2)Know the potential therapist traits that influence the use of CBT techniques. (3)Gain knowledge to help explain to clients why previous therapy may not have been effective. (4)Develop a richer understanding of what factors may influence their own therapeutic practice.

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