A randomized controlled trial of the judicious use of safety behaviors during exposure therapy

Blakey, Shannon M.; Abramowitz, Jonathan S.; Buchholz, Jennifer L.; Jessup, Sarah C.; Jacoby, Ryan J.; Reuman, Lillian

doi:10.1016/j.brat.2018.11.010

Cited by 30 publications

(10 citation statements)

References 31 publications

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“…Supporting this view, Goetz et al (2016) found little evidence of negative treatment outcomes associated with safety behavior usage in their systematic review of the anxiety treatment literature. Similarly, Blakey et al (2019) tested the effects of safety behavior usage during exposure therapy amongst participants with spider phobia who were randomly assigned to use or drop safety behaviors. Results indicated that participants in the two conditions did not differ in their assessment of the tolerability of the exposure exercises or in their peak distress levels or levels of distress tolerance.…”

Section: Mask-wearing As a Safety Behaviourmentioning

confidence: 99%

Effects of mask-wearing on social anxiety: an exploratory review

Saint

Moscovitch

2021

Anxiety, Stress, & Coping

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Background: A unique feature of the global coronavirus pandemic has been the widespread adoption of mask-wearing as a public health measure to minimize the risk of contagion. Little is known about the effects of increased mask-wearing on social interactions, social anxiety, or overall mental health. Objectives: Explore the potential effects of mask-wearing on social anxiety. Design: We review existing literatures to highlight three preselected sets of factors that may be important in shaping the effects of mask-wearing on social anxiety. These are: (a) people's perceptions of the social norms associated with wearing masks; (b) people's experiences of the degree to which masks prevent accurate interpretation of social and emotional cues; and (c) people's use of masks as a type of safety behavior that enables self-concealment. Methods: APA PsycNet and PubMed were searched principally between September and November 2020 for articles describing the relationship between social anxiety, intolerance of uncertainty, ambiguous feedback, and safety behavior use and for research on the relationship between mask-wearing and social norms and social interactions. Information identified as relevant from articles of interest was extracted and included in our review.Results & Conclusions: The effects of mask-wearing on social anxiety are likely to be substantial and clinically relevant.

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Section: Mask-wearing As a Safety Behaviourmentioning

confidence: 99%

Effects of mask-wearing on social anxiety: an exploratory review

Saint

Moscovitch

2021

Anxiety, Stress, & Coping

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“…Our considerations are in line with Wu et al [ 9 ] who proposed that Family Accommodation operates contrary to the goals of exposure and response prevention, the first line treatment for OCD [ 46 , 47 ]. Indeed, as suggested by Blakey et al [ 48 ], within the Cognitive Behavioral Therapy (CBT) approach, exposure consists in repeated and prolonged confrontation with situations and stimuli that trigger obsessions (e.g., books ordered the “wrong way”). Response prevention includes resisting urges to perform behaviours such as avoidance and compulsive rituals (e.g., ordering) during and after exposure trials.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of family accommodation and parental psychological distress in a sample of children and adolescents with obsessive-compulsive disorder aged 8-17 years old

et al. 2020

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Background Family Accommodation (FA) refers to the involvement of family members (especially parents) in the compulsive behaviors of children and adolescents with Obsessive-Compulsive Disorder (e.g. modifying family routines or facilitating avoidance of obsessive-compulsive triggers). Many studies have examined the high prevalence of FA in this clinical population; however, less is known about its clinical significance and relationship to the individual psychological distress of parents. In our study, we investigated the clinical significance of FA examining its relationship with obsessive-compulsive symptomatology, functioning, anxiety and depressive symptoms in a clinical sample (n = 51) of children and adolescents with Obsessive-Compulsive Disorder (OCD) aged 8–17 years old and their parents, included to examine their individual psychological distress. Methods The sample was divided into two groups: the High Accommodation group (n = 36) and the Low Accommodation group (n = 15). Results Results demonstrated that children and adolescents in the OCD High Accommodation group reported major functional impairment in global (p = .001313), social (p = .000334) and role (p = .000334) domains, and higher depressive symptoms than the Low Accommodation group. Both fathers and mothers from the High Accommodation group reported a higher level of individual psychological distress compared to mothers and fathers from the Low Accommodation group (p = .040365). Conclusions The findings of this study show that FA is common in children and adolescents with OCD and it could cause not only an impairment of the patient’s global, social and role functioning but also a high level of individual psychological distress in the single parent. The presence of FA should therefore be carefully investigated and considered in planning assessment and treatment of OCD in children and adolescents.

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“…Regarding FA, clinicians may not need to be overly focused or concerned if parents are unwilling to eliminate all FA, at least initially, as long as the parent and child can explicitly test their fear-based expectancies through exposure with the feared situation or event. Instead of the metric of success being reduction in affect, the development of new non-threat associations and the enhancement of accessible and retrievable newly learned associations may increase the effectiveness of exposure (Blakey et al, 2019). Thus the goal of exposure within the ACT framework mirrors that of inhibitory learning theory in that the individual learns to act with the feared situation in a more functional manner so that the individual moves in the direction of values and things that are important and that are currently disrupted (Twohig et al, 2015), in this case the parent-child relationship.…”

Section: Committed Actionmentioning

confidence: 99%

The use of acceptance and commitment therapy (ACT) in addressing family accommodation (FA) for child anxiety

Byrne

2021

tCBT

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Many parents of children with anxiety tend to engage in varying levels of family accommodation (FA) in order to alleviate anxiety symptoms. This can exacerbate anxiety symptoms and have adverse effects for psychological treatments. A small number of general and specific interventions have been developed for FA but treatment research is at a nascent stage. Acceptance and commitment therapy (ACT) may be an effective treatment for FA. This article reviews the potential advantages and uses of ACT and how ACT’s six core processes can help target particular features of FA. The theoretical support for ACT is reviewed relevant to FA. The article concludes by conjecturing how ACT may be a useful and adaptive treatment in targeting FA. Key learning aims (1) To understand how FA impacts on child anxiety. (2) To help provide an overview of how ACT may be a relevant treatment in addressing FA. (3) To look at how each of the six core processes may address specific components of FA.

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A randomized controlled trial of the judicious use of safety behaviors during exposure therapy

Cited by 30 publications

References 31 publications

Effects of mask-wearing on social anxiety: an exploratory review

Effects of mask-wearing on social anxiety: an exploratory review

Clinical significance of family accommodation and parental psychological distress in a sample of children and adolescents with obsessive-compulsive disorder aged 8-17 years old

The use of acceptance and commitment therapy (ACT) in addressing family accommodation (FA) for child anxiety

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