Is there room for safety behaviors in exposure therapy for anxiety disorders?

Abstract

Exposure-based treatments are often regarded as one of the major success stories in the treatment of anxiety disorders McNally (Clinical Psychology Review 27(6):750–759, 2007). Encouraging patients to confront anxiety-provoking cues is a central element in most empirically supported treatments for the anxiety disorders. Consequently, it only makes sense for clinical scientists to investigate procedural factors that influence the efficacy of exposure treatments. One procedural issue that has recently become the focus of considerable research and some controversy is whether to make safety behaviors available during exposure treatment Rachman et al. (Behaviour Research and Therapy 46(2):163–173, 2008). The overarching aim of this chapter is to provide an up-to-date report on the status of safety behavior research in the context of exposure therapy and to provide clinicians specific recommendations for the (a) clinical assessment of safety behaviors; (b) strategies for helping patients withdraw anxiogenic safety behaviors; and (c) strategies for utilizing safety behaviors to enhance exposure treatments.