Practitioners’ use of exposure therapy in older adults with anxiety disorders

ABSTRACT Objective Despite the empirical support for exposure therapy, it is unclear how many community-dwelling older adults with anxiety disorders receive this intervention. This study examined the use of exposure therapy compared to other treatment techniques among clinicians who treat older adults with anxiety disorders. Method 60 registered mental health treatment providers (e.g., psychologists, clinical psychologists) (M = 44 years, 83.3% female) completed self-report questionnaires assessing the frequency of use of exposure therapy and other treatment techniques for older clients with anxiety disorders, as well as beliefs about the safety and tolerability of exposure for older adults. Results Compared to younger anxious clients, clinicians endorsed significantly less frequent use of exposure therapy than other treatment techniques in older anxious adults. Negative therapist beliefs about the safety and tolerability of exposure therapy were significantly associated with infrequent use of exposure therapy in older adult clients. Clinical qualification was also associated with therapist beliefs about the exposure therapy, with clinicians who hold postgraduate qualifications reporting less negative therapist beliefs about exposure. Conclusions Current findings indicate there may be a need to address negative clinician attitudes towards the use of exposure therapy when working with anxious older clients. KEY POINTS What is already known about this topic: Anxiety disorders are common mental disorders in older adults. Exposure-based cognitive behavioural therapy is highly effective in anxiety treatment. Clinicians trained in exposure therapy rarely deliver exposure therapy or they deliver this therapy in a less effective manner. What this topic adds: Exposure therapy is under-delivered in older adults with anxiety Negative beliefs about exposure therapy are associated with underuse of exposure therapy in older adults. Clinical training should address negative clinician attitudes towards the use of exposure therapy when working with anxious older clients.