Exposure therapy in patients with harm-related obsessive-compulsive disorder: The theory-practice gap and its relation to experiential avoidance and negative beliefs about exposure
Lena Jelinek , Alicia Balzar , Steffen Moritz , Sarah Liebherz , Amir H. Yassari
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Abstract
Despite its efficacy and effectiveness, exposure with response prevention (ERP) is underused in patients with obsessive-compulsive disorder (OCD). As this underuse of ERP may apply particularly to harm-related OCD, we investigated the theory-practice gap as well as negative beliefs and experiential avoidance as potential reasons for the underutilization of ERP with this group in a sample of trainee and qualified therapists.
We assessed 339 therapists’ general knowledge about ERP using a harm-related OCD case example and their utilization of ERP in clinical practice for harm-related OCD. Of the total sample, 74% of the therapists (n = 251) were CBT-oriented and 61% (n = 209) were in training. We assessed negative beliefs and experiential avoidance using the Therapist Beliefs about Exposure Scale (TBES) and the Acceptance and Action Questionnaire-II (AAQ-II).
While 74% of the therapist recommended ERP for the case example, only 43% admitted to using ERP for harm-related OCD in their clinical practice. ERP affinity of therapists in theory and practice was related to fewer negative beliefs about ERP, with large effect size (ηp2 = 0.367 [CI95% 0.285 − 0.433]) and lower experiential avoidance with small effect size (ηp2 = 0.024 [CI95% 0.001 − 0.059]) in the total sample.
We found evidence of a theory-practice gap in the treatment of harm-related OCD in a sample of trainee and qualified therapists. To ensure that patients with harm-related OCD content receive the evidence-based treatment they need, negative beliefs about ERP may represent a potential target.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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