Practitioners’ use of exposure therapy in older adults with anxiety disorders

ABSTRACT

Objective

Despite the empirical support for exposure therapy, it is unclear how many community-dwelling older adults with anxiety disorders receive this intervention. This study examined the use of exposure therapy compared to other treatment techniques among clinicians who treat older adults with anxiety disorders.

Method

60 registered mental health treatment providers (e.g., psychologists, clinical psychologists) (M = 44 years, 83.3% female) completed self-report questionnaires assessing the frequency of use of exposure therapy and other treatment techniques for older clients with anxiety disorders, as well as beliefs about the safety and tolerability of exposure for older adults.

Results

Compared to younger anxious clients, clinicians endorsed significantly less frequent use of exposure therapy than other treatment techniques in older anxious adults. Negative therapist beliefs about the safety and tolerability of exposure therapy were significantly associated with infrequent use of exposure therapy in older adult clients. Clinical qualification was also associated with therapist beliefs about the exposure therapy, with clinicians who hold postgraduate qualifications reporting less negative therapist beliefs about exposure.

Conclusions

Current findings indicate there may be a need to address negative clinician attitudes towards the use of exposure therapy when working with anxious older clients.

KEY POINTS

What is already known about this topic:

1. Anxiety disorders are common mental disorders in older adults.

2. Exposure-based cognitive behavioural therapy is highly effective in anxiety treatment.

3. Clinicians trained in exposure therapy rarely deliver exposure therapy or they deliver this therapy in a less effective manner.

What this topic adds:

1. Exposure therapy is under-delivered in older adults with anxiety

2. Negative beliefs about exposure therapy are associated with underuse of exposure therapy in older adults.

3. Clinical training should address negative clinician attitudes towards the use of exposure therapy when working with anxious older clients.

KEYWORDS:

• Anxiety disorder
• cognitive behaviour therapy
• exposure
• older adults

Acknowledgement

Jessamine Chen designed the study, carried out data collection, analysed the data, and prepared the manuscript. Viviana Wuthrich co-deigned the study, assisted with data analysis and manuscript preparation. Dino Zagic assisted with data collection and manuscript preparation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.