Exposure therapy for anxiety disorders: Is there room for cognitive interventions?

Abstract

Exposure therapy has a long tradition in the behavioral treatments for anxiety disorders. It originally rested upon a learning theoretical account on the acquisition and maintenance of human fears. As cognitive therapy entered the stage and became increasingly popular, it in many ways embraced the behavioral procedure of exposure within a cognitive model. This also meant that exposure procedures were supplemented with specific interventions intended to modify thought content, presumed to maintain the fear. Contrary to expectations, almost 30 years of research has not consistently proven this approach to be more efficacious than the traditional approaches. At the moment, we see a resurgence of interest in learning theoretical accounts, guiding the further development of exposure therapy for anxiety disorders. So the question appears: What room will there be in this therapy for, so-called, cognitive interventions? Are they to be considered superfluous or do they retain some value on theoretical grounds within the realms of learning theory?.