In a previous post, I linked to a blog post about therapist reluctance to use exposure therapy. Exposure therapy is one of the most effective interventions for anxiety-related problems but, sadly, remains under-utilized by clinicians. It is an intervention that has been a major focus on my posts on this blog.

A recent study out of Drexel University looks at the role of experiential avoidance in therapist reluctance to use exposure therapy to treat OCD. Experiential avoidance (EA) refers to a tendency to avoid uncomfortable thoughts, feelings, and bodily sensations, and is a cornerstone in the model of psychopathology in Acceptance and Commitment Therapy.

Methods

The researchers recruited 172 clinicians who identified as cognitive behavioral therapists. Each participant completed self-report measures of EA, attitude towards evidence-based practice, thinking style, and treatment approaches. These therapists watched 2 of 4 possible video vignettes featuring actors portraying people with OCD based on scripts that were vetted by OCD experts. The therapists then rated how much time they would allot for different therapy techniques in treating the case example.

Findings

The researchers found that therapists who scored higher on experiential avoidance (EA) reported they would devote less time to using exposure for treating OCD clients in the vignettes they watched. This is striking as exposure is the gold standard treatment for OCD. Additionally, therapists who scored higher in EA showed a lower preference towards evidence-based practice. An interesting gender finding was that women exhibited a greater preference for evidence-based practice than men.

As the authors note, it’s impossible to derive a causal relationship between these variables. For example, they speculate that therapists who are more experienced in exposure may develop lower EA because of they themselves get used to doing exposure. In support of this view, the authors note that therapists who spent a larger portion of their time doing clinical work exhibited lower EA.

Overall, this study suggests that higher experiential avoidance may be a barrier to using exposure therapy and evidence-based practices.

Check out the article!

If you’re a member of the Association for Contextual Behavioral Science, you can download a copy of the article here if you log into your account.