Assessing Success

Chapter 4 describes the core yardsticks of improvement. The chapter describes how success is defined from both patient and therapist perspectives and how this is modified from early to later sessions. Patients naturally want to have less anxiety. Therapists, however, know the only way to achieve this goal is to go through (rather than around) the discomfort. Once fear is no longer the enemy, the anxiety eventually goes away. Assessment includes actions and measures before, during, and after exposure. Overall, exposure therapy is on track when the patient is approaching his or her feared cues, responding differently to fear/emotions/thoughts, and shifting his or her specific appraisals of threat to appraisals of safety. Finally, we also describe the importance of assessing patient engagement and command of the exposure therapy model.