Author: Schumacher, Sarah; Miller, Robert; Fehm, Lydia; Kirschbaum, Clemens; Fydrich, Thomas; Strohle, Andreas
Description: Exposure therapy is considered an effective treatment strategy for phobic anxiety, however, it is rarely applied in clinical practice. The under-usage might be due to various factors of which heightened stress levels not only in patients but also in therapists are presumed to be of particular relevance. The present study aimed to investigate whether different forms of exposure might lead to varying physiological and psychological stress responses in therapists and phobic patients. 25 patients with specific phobia underwent individual cognitive behavioral therapy, performed by 25 psychotherapist trainees, applying exposure sessions in graduated form or the flooding technique. Patients and therapists provided subjective evaluations of stress and five saliva samples for analysis of salivary cortisol and alpha-amylase either during two graduated exposure sessions or during one flooding session, while a regular therapy session served as control condition. Therapists displayed heightened salivary alpha-amylase release during exposure of the flooding, but not the graduated, type. Patients showed elevated salivary cortisol during flooding exposure numerically, however, not on a statistically significant level. Therapists reported more pronounced subjective stress during flooding compared to graduated exposure. Elevated stress levels should be addressed in clinical training in order to improve application of exposure in routine practice.
Subject headings: Adult; Anxiety; Cognitive Behavioral Therapy; Female; Humans; Hydrocortisone; Implosive Therapy; Male; Phobic Disorders; Psychotherapy; Saliva; Stress, Psychological; Exposure therapy; Psychotherapist trainees; Salivary alpha-amylase; Salivary cortisol; Specific phobia
Publication year: 2015
Journal or book title: Psychiatry Research
Volume: 230
Issue: 2
Pages: 668-675
Find the full text: https://www.sciencedirect.com/science/article/abs/pii/S0165178115300421
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Serial number: 3250