Further Support for the Acceptability-Enhancing Roles of Safety Behavior and a Cognitive Rationale in Cognitive Behavioral Therapy for Anxiety Disorders

It has been proposed that the judicious use of safety behavior may enhance the acceptability of cognitive behavioral therapy (CBT). Indeed, Milosevic and Radomsky (2013a) found that descriptions of CBT incorporating safety behavior were more acceptable than those that discouraged safety behavior. This study aimed to replicate and extend this work. Participants were 688 undergraduates who rated the acceptability of descriptions of CBT varying in safety behavior (judicious or discouraged) and rationale (cognitive or extinction). Consistent with Milosevic and Radomsky, CBT with safety behavior was significantly more acceptable than traditional CBT. Cognitively based CBT was preferred over extinction-based CBT. The effects of prior treatment and general distress were also examined. Overall, previous treatment and greater anxiety were associated with significantly lower acceptability ratings. Results support the acceptability-enhancing role of safety behavior in CBT and are discussed in terms of cognitive-behavioral theory and treatment of anxiety and related disorders.

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Supplemental Material for Who Gets the Most Out of Cognitive Behavioral Therapy for Anxiety Disorders? The Role of Treatment Dose and Patient Engagement

Journal of Consulting and Clinical Psychology ◽

10.1037/a0033403.supp ◽

2013 ◽

Keyword(s):

Cognitive Behavioral Therapy ◽

Anxiety Disorders ◽

Patient Engagement ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Treatment Dose

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Supervising Child Psychiatry Fellows in Cognitive Behavioral Therapy: Crucibles and Choices

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.27.1.61 ◽

2013 ◽

Vol 27 (1) ◽

pp. 61-70 ◽

Cited By ~ 4

Author(s):

Amanda M. Pearl ◽

Fauzia Mahr ◽

Robert D. Friedberg

Keyword(s):

Cognitive Behavioral Therapy ◽

Mental Health Professionals ◽

Clinical Skills ◽

Behavioral Therapy ◽

Early Career ◽

Behavioral Theory ◽

Cognitive Behavioral ◽

Affective Arousal ◽

Child Psychiatric ◽

Cognitive Behavioral Theory

Child psychiatric fellows enter cognitive behavioral therapy (CBT) training experiences with a wide variety of backgrounds and experiences in this area of treatment. Although some child fellows have fundamental knowledge of cognitive-behavioral theory, most struggle with the CBT model and even more so, subsequently using this model to guide treatment. Unlike supervising early career mental health professionals, child residents often possess a skill set apt for CBT including using a problem-oriented focus, a tendency to use structured methods in treatment, the use of psychoeducation, and basic clinical skills including genuineness, understanding, and empathy. On the other hand, child psychiatric fellows find several areas of CBT challenging because it is often vastly different from previous experience, including more frequent and longer sessions, the use of collaborative empiricism, developing case conceptualizations, and tolerating negative affective arousal. Moreover, training climates in psychiatry departments may shape the supervision experiences. Various specific recommendations are offered to manage these crucibles. Overall, although there are significant challenges when supervising child residents in CBT rotations, having knowledge of these crucibles and access to choices for addressing these supervisory tests enhances both supervisor and supervisee competence.

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Who gets the most out of cognitive behavioral therapy for anxiety disorders? The role of treatment dose and patient engagement.

Journal of Consulting and Clinical Psychology ◽

10.1037/a0033403 ◽

2013 ◽

Vol 81 (4) ◽

pp. 639-649 ◽

Cited By ~ 64

Author(s):

Daniel Glenn ◽

Daniela Golinelli ◽

Raphael D. Rose ◽

Peter Roy-Byrne ◽

Murray B. Stein ◽

...

Keyword(s):

Cognitive Behavioral Therapy ◽

Anxiety Disorders ◽

Patient Engagement ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Treatment Dose

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Integrated Cognitive Behavioral Therapy for Anxiety and Smoking Cessation

Clinical Case Studies ◽

10.1177/1534650119859094 ◽

2019 ◽

Vol 18 (5) ◽

pp. 378-396

Author(s):

Julia D. Buckner ◽

Michael J. Zvolensky ◽

Katherine Walukevich-Dienst ◽

Elizabeth M. Lewis ◽

Kimberlye E. Dean ◽

...

Keyword(s):

Smoking Cessation ◽

Anxiety Disorder ◽

Cognitive Behavioral Therapy ◽

Anxiety Disorders ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Safety Behavior ◽

Smoking Cessation Treatment ◽

Diagnostic Threshold ◽

Cessation Treatment

Smokers suffer from high rates of anxiety disorders, presumably because some individuals with anxiety disorders rely on smoking as a maladaptive attempt to manage anxiety. Cognitive behavioral therapy (CBT) is an efficacious smoking cessation treatment, yet outcomes are worse for patients with elevated anxiety. The integration of CBT for smoking cessation with False Safety Behavior Elimination Therapy (FSET) may be useful with anxious smoking cessation patients, as smoking to manage anxiety and associated negative affect can be targeted as a false safety behavior (i.e., behavior aimed at decreasing anxiety in the short-term but which may maintain or exacerbate it in the long-term). Here, we describe the integrated treatment, Treatment for Anxiety and Smoking Cessation (TASC), and the successful use of it with two smoking cessation patients—one with comorbid generalized anxiety disorder (GAD) and one with clinically elevated social anxiety that did not meet diagnostic threshold for an anxiety disorder. Data support the feasibility of TASC as a viable approach to smoking cessation treatment for patients with comorbid anxiety disorder and with elevated anxiety that does not meet diagnostic threshold. Future controlled trials are now warranted to further evaluate the intervention.

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Mindfulness and Cognitive Behavioral Therapy: A Commentary on Harrington and Pickles

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.23.4.324 ◽

2009 ◽

Vol 23 (4) ◽

pp. 324-332 ◽

Cited By ~ 9

Author(s):

Ruth A. Baer ◽

Shannon Sauer

Keyword(s):

Cognitive Behavioral Therapy ◽

Clinical Psychology ◽

Behavioral Therapy ◽

Behavioral Theory ◽

Scientific Study ◽

Cognitive Behavioral ◽

Cognitive Behavioral Theory

Harrington and Pickles (this issue) raise interesting and important questions about the nature of mindfulness and its relationships to scientific clinical psychology and cognitive behavioral theory and treatment. In this commentary, we address two primary questions. First, is mindfulness a meaningful concept within scientific clinical psychology or is it religious or mystical? Second, is mindfulness compatible with cognitive behavioral therapy? We argue that mindfulness can be conceptualized as a nonreligious construct suitable for scientific study and that it can be integrated with cognitive behavioral therapy in interesting and fruitful ways.

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