Training In CBT & Other Evidence-Based Psychological Therapies
Introduction
Exposure therapy is simple in principle, anchored in theory, and richly open to clinical innovation. And it works! Exposure-based cognitive-behavior therapy (CBT) provides patients with successive experiences designed to help them overcome fears and re-establish adaptive behavior in the situations that characterize anxiety- and fear-related disorders. This presentation will take a broad-based perspective on the clinical procedures and the mechanisms of change that underlie successful treatment of panic disorder, PTSD, social anxiety disorder, obsessive-compulsive disorder, generalized anxiety disorder, and specific phobias. Discussions of treatment targets and strategies for enduring change are stressed throughout this presentation.
The event will be equivalent to 2 hrs of CPD.
Content
This presentation is designed to provide an overview of the state of the art of exposure therapy. Elements and targets of exposure therapy will be discussed, along with up-to-date information on investigations of mechanisms underlying exposure therapy. Core attention is placed on “what does the patient learn” from individual exposures, and these considerations will be placed in a broader and “memory-centric” perspective on therapeutic learning in CBT more generally. Individual topics include:
• Steps to socialize patients to exposure therapy and becoming an accurate observer of expectancies and outcomes
• The role of interoceptive exposure in initiating exposure therapy, reflecting the importance of first helping patients develop adaptive responses to the anxiety experience itself
• The importance of attending to safety behaviors and directly programming adaptive responses to fear cues.
• Considerations on post-exposure processing and the role of memory reactivation between sessions
• Considerations on factors that influence (moderate) the nature of learning in exposure therapy
• Considerations for addressing issues brought by the combination of exposure therapy and medication treatments
Learning Objectives
1. Attend to fears of symptoms as an initial treatment target
2. Design exposure therapy targets (which component of fear/avoidance to target in each session)
3. Describe the learning processes underlying clinical gains
4. Describe moderators of exposure therapy outcomes
Training Modalities
Didactic content, clinical examples, self-experiential components, Q&A
Key References
Benito, K., Pittig, A., Abramowitz, J., Arch, J., Chavira, D., de Kleine, R., De Nadai, A., Hermans, D., Hofmann, S.G., Hoyer, J., Huppert, J.D., Kircanski, K., McEvoy, P.M., Meyer, H., Monfils, M.H., Papini, S., Rief, W., Rosenfield, D., Storch, E.A., Telch, M.J., Otto, M.W., Smits, J.A., for the Exposure Therapy Consortium (2024). Mechanisms of Change in Exposure Therapy for Anxiety and Related Disorders: A Research Agenda. Clinical Psychological Science. 0(0). https://doi.org/10.1177/21677026241240727
Fitzgerald. H.E., Hoyt. D.L., Kredlow. M.A., Smits. J.A.J., Schmidt. N.B., Edmondson. D., & Otto, M.W. (2021). Anxiety sensitivity as a malleable mechanistic target for prevention interventions: a meta-analysis of the efficacy of brief treatment interventions. Clinical Psychology: Science and Practice, 28(4), 323-337.
Kredlow, M. A., Eichenbaum, H., & Otto, M. W. (2018). Memory creation and modification: Enhancing the treatment of psychological disorders. American Psychologist, 73(3), 269–285.
Monfils MH, Lee HJ, Raskin M, Niv Y, Shumake J, Telch MJ, Smits J, & Otto MW (2024). Fear attenuation collaborations to optimize translation. Behavioural Neuroscience, 138(3), 152-163.
Smits, J. A. J., Powers, M. B., & Otto, M.W. (2019) Personalized Exposure Therapy: A Person-Centered Transdiagnostic Approach. New York: Oxford University Press.
Taylor, C. T., Rosenfield, D., Dowd, S. M., Dutcher, C. D., Hofmann, S. G., Otto, M. W., Pollack, M. H., & Smits, J. A. J. (2023). What good are positive emotions for treatment? A replication test of whether trait positive emotionality predicts response to exposure therapy for social anxiety disorder. Behaviour Research and Therapy, Dec:171:104436
About the presenter
Michael W. Otto, Ph.D., is Professor in Psychological and Brain Sciences at Boston University. Dr. Otto has had a major career focus on developing and validating new psychosocial treatments for mood, anxiety, and substance use disorders. This work includes a translational research agenda investigating brain-behavior relationships in therapeutic learning. Attention to principles underlying behavior-change failures led him to an additional focus on health-behavior promotion, including investigations of addictive behaviors, medication adherence, sleep, and exercise. Dr. Otto has over 25 years of continuous funding from NIH, and has published over 500 articles, chapters, and books spanning his research interests. He has been identified as a “top producer” in the clinical empirical literature, an ISI Highly Cited Researcher, and recipient of the Distinguished Scientific Contributions to Clinical Psychology award from the American Psychological Association, Division 12 and the 2024 Outstanding Researcher award from the Association for Behavioral and Cognitive Therapies (ABCT). He is also recipient of a 2019 Elizabeth Hurlock Beckman Award for excellence in mentoring from the American Psychological Association and the 2023 Toy Caldwell-Colbert Award for Distinguished Educator in Clinical Psychology. Dr. Otto is past President of the Association for Behavioral and Cognitive Therapies and Past President of the American Psychological Association Division 12, and his service to the field was recognized in 2010 by an Outstanding Service Award from ABCT. Dr. Otto is a regular provider of continuing education and continuing medical education workshops. In addition, Dr. Otto has been a frequent consultant to industry, and the broad scope of his work has led to popular media coverage in the New York Times, Wall Street Journal, Scientific American-Mind, Runner’s World, Self, and Outside Magazine. He also a firm believer in team science and serves as founder of the Mechanistic Behavior Research Consortium (https://www.mbrc-sobc.org/) and a member of the Exposure Therapy Consortium (https://www.exposuretherapyinfo.org/).
Who should attend
This event is designed for clinical providers with initial experience conducting exposure-based therapy who want to enhance their skills by aligning techniques and the progression of therapy with cutting-edge perspectives on empirically-supported principles of change.