Maximizing Exposure Therapy: An Inhibitory Learning Approach

By Michelle G. Craske, M. Treanor, C. Conway, T. Zbozinek, Bram Vervliet. Behaviour Research and Therapy, 2014

1,913 citations recorded by the source corpus.

Exposure therapy is an effective approach for treating anxiety disorders, although a substantial number of individuals fail to benefit or experience a return of fear after treatment. Research suggests that anxious individuals show deficits in the mechanisms believed to underlie exposure therapy, such as inhibitory learning. Targeting these processes may help improve the efficacy of exposure-based procedures. Although evidence supports an inhibitory learning model of extinction, there has been little discussion of how to implement this model in clinical practice. The primary aim of this paper is to provide examples to clinicians for how to apply this model to optimize exposure therapy with anxious clients, in ways that distinguish it from a ‘fear habituation’ approach and ‘belief disconfirmation’ approach within standard cognitive-behavior therapy. Exposure optimization strategies include 1) expectancy violation, 2) deepened extinction, 3) occasional reinforced extinction, 4) removal of safety signals, 5) variability, 6) retrieval cues, 7) multiple contexts, and 8) affect labeling. Case studies illustrate methods of applying these techniques with a variety of anxiety disorders, including obsessive-compulsive disorder, posttraumatic stress disorder, social phobia, specific phobia, and panic disorder.

Subfields: Cognitive Neuroscience, Experimental and Cognitive Psychology

View Paper: https://www.semanticscholar.org/paper/0d5de00a9991db7a0f004d29efca3e1c6f367c0f

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Citations in the corpus

Transforming Experience: The Potential of Augmented Reality and Virtual Reality for Enhancing Personal and Clinical Change (2016, result): “These studies are in agreement with the results obtained by Craske et al. (89) on the inhibitory learning approach presenting exposure optimization strategies such as (a) “deepened 3 studies “There is no clear good quality evidence for or against using virtual reality for treatment compliance among…”
Catastrophic Thinking: A Transdiagnostic Process Across Psychiatric Disorders (2016, background): “By utilizing exposures that maximally violate the client’s expectancies about aversive outcomes, deeper inhibitory learning takes place, facilitating memory consolidation (Craske et al. 2014).”
Large language models could change the future of behavioral healthcare: a proposal for responsible development and evaluation (2024, background): “At the level of health systems, they could expedite the implementation and translation of research ﬁ ndings into clinical practice by suggesting therapeutic strategies to psy-chotherapists, for instance, promoting strategies that enhance inhibitory learning during exposure therapy 84 .”
Using Neuroscience to Help Understand Fear and Anxiety: A Two-System Framework. (2016, background): “anxiety evoked during exposure (132), postexposure consolidation (120), or the use of particular outcome measures to”