Table of Contents

I. The Fundamentals of Exposure Therapy
1. Overview and History of Exposure Therapy for Anxiety
2. How Well Does Exposure Therapy Work?
3. The Nature and Treatment of Clinical Anxiety
4. Treatment Planning I: Functional Assessment
5. Treatment Planning II: Treatment Engagement and Exposure List Development
6. Implementing Exposure Therapy
II. Implementing Exposure Therapy for Specific Types of Fears
7. Animal-Related Fears
8. Environmental Fears
9. Social Situations
10. Unwanted Intrusive Thoughts
11. Bodily Cues and Health Concerns
12. Contamination
13. Trauma-Focused Fear
14. Blood-, Injection-, and Injury-Related Stimuli
15. Incompleteness, Asymmetry, and "Not-Just-Right" Feelings
III. Special Considerations in the Use of Exposure Techniques
16. Exposure Therapy with Complex Cases
17. Exposure Therapy with Children
18. Involving Significant Others in Treatment
19. Combining Exposure Therapy with Medication
20. Maintaining Improvement after Treatment
21. Using Technology to Implement Exposure Therapy
22. Using Acceptance and Commitment Therapy with Exposure
23. A Risk–Benefit Analysis of Exposure Therapy

About the Author

Jonathan S. Abramowitz, PhD, ABPP, is Professor of Psychology and Neuroscience, Research Professor of Psychiatry, and Director of the Anxiety and Stress Disorders Clinic at the University of North Carolina at Chapel Hill. Dr. Abramowitz conducts research on anxiety disorders and has published over 250 articles, book chapters, and books. He serves as Editor of the Journal of Obsessive–Compulsive and Related Disorders and is on the editorial boards of several other scientific journals. He is past president of the Association for Behavioral and Cognitive Therapies and serves on the scientific and clinical advisory board of the International OCD Foundation. Dr. Abramowitz is a recipient of the Outstanding Contributions to Research Award from the Mayo Clinic Department of Psychiatry and Psychology and the David Shakow Early Career Award for Distinguished Scientific Contributions to Clinical Psychology from Division 12 of the American Psychological Association. His books include Getting Over OCD, Second Edition, and The Stress Less Workbook (for general readers) and Exposure Therapy for Anxiety, Second Edition (for mental health professionals).

Brett J. Deacon, PhD, is a clinical psychologist in private practice in Wollongong, Australia, and Conjoint Associate Professor at the University of New South Wales. He has published approximately 100 research articles and book chapters, served as Editor of The Behavior Therapistand Associate Editor of the Journal of Cognitive Psychotherapy, and is an editorial board member of numerous scientific journals. Dr. Deacon’s research examines the dissemination, optimal delivery, and acceptability of exposure therapy for anxiety. He is the recipient of numerous teaching, research, and student mentorship awards from the University of Wyoming, as well as the Golden Anniversary Alumni Award from Northern Illinois University College of Liberal Arts and Sciences. Dr. Deacon presents workshops around the world on exposure therapy.

Stephen P. H. Whiteside, PhD, ABPP, is Professor of Psychology and Director of the Pediatric Anxiety Disorders Program at the Mayo Clinic in Rochester, Minnesota. His research focuses on improving access to evidence-based care for pediatric anxiety disorders and obsessive–compulsive disorder through the development of effective and efficient treatments facilitated by technology. Dr. Whiteside serves on the editorial board of the Journal of Anxiety Disorders and on the Education and Training Committee of the Minnesota Psychological Association. He has published over 60 scientific articles and is the codeveloper of the Mayo Clinic Anxiety Coach, a smartphone app that aids in the delivery of exposure.

Reviews

"An outstanding volume for providers, students, and researchers who want to understand not only what to do when conducting exposure therapy, but also how to do it, and why it works. The second edition integrates the latest research on the learning processes that are critical to making exposures work, and provides clear guidance on how to use the research findings to directly improve clinical practice. Clients treated by providers who have read this book should be in good hands!"--Bethany A. Teachman, PhD, Department of Psychology, University of Virginia

"This second edition remains the definitive book on exposure therapy for anxiety-related problems. It is comprehensive, clearly written, practical, and fully updated to reflect contemporary research and theory on exposure-based treatments. This book is an invaluable resource for novice and expert therapists alike, and it should be required reading for any student training in cognitive-behavioral therapy."--Martin M. Antony, PhD, ABPP, Department of Psychology, Toronto Metropolitan University, Canada

"The authors do an excellent job of dispelling therapists' common fears about implementing exposure therapy. They review the evidence base for the approach and separate facts from myths. Clinicians treating trauma may have concerns about retraumatizing patients; instead of dismissing these concerns, the authors validate them and provide solutions. I recommend this book as a 'must read' for clinicians at all levels of practice."--Johanna Kaplan, PhD, Director, Washington Anxiety Center of Capitol Hill, Washington, DC

“The authors do a splendid job of presenting the core clinical features that cut across all anxiety and trauma-related disorders. In so doing, they provide the reader a helpful heuristic for assisting in case formulation and treatment planning. Coverage of safety behaviors and their role in maintaining and exacerbating anxiety is particularly important, given that many clinicians still instruct anxiety patients to utilize safety behaviors to cope with their anxiety. I will assign this book as a required reading for my practicum course in evidence-based treatments."--Michael J. Telch, PhD, Professor of Psychology and Founding Director, Laboratory for the Study of Anxiety Disorders, The University of Texas at Austin

"Exposure has served as the treatment of choice for anxiety disorders for decades, despite many new therapies trying to take its mantle. Yet too many clinical practitioners either avoid using exposure or implement it suboptimally. Already the go-to resource on exposure therapy, this second edition elegantly balances the latest science and art of delivering this most effective therapy in the most effective manner."--Peter J. Norton, PhD, Cairnmillar Institute, Melbourne, Australia

"I have been training clinical psychology doctoral students in exposure-based CBT for all forms of anxiety for more than two decades, and have found this book to be invaluable in my advanced elective course on the topic. The authors are among the best in the field. The book has excellent coverage of the theory and science behind exposure, which is critical for my doctoral students to understand in order to implement the interventions successfully. There is also attention given to important 'in the trenches' issues for future clinicians. This is an outstanding graduate-level book."--Lisa Lilenfeld, PhD, Clinical Psychology Program, The Chicago School of Professional Psychology, Washington, DC -An invaluable reference and practical guide for new therapists and seasoned practitioners alike….The authors aptly revised their book in this second edition consistent with advances in research and the field's understanding of anxiety. Most notably, the authors moved to an inhibitory learning perspective from the emotional processing perspective that underscored the text's first edition….The book is a must-read for students and trainees as well as seasoned clinicians looking for a comprehensive, practical, readable text that is rooted in contemporary research….With numerous case examples and practical tips and recommendations, the expert authors do an excellent job increasing reader confidence in the application and benefit of utilizing therapeutic exposure in practice, while simultaneously dispelling common fears and concerns about exposure therapy.--Journal of Contemporary Psychotherapy, 9/1/2020ƒƒAn excellent compendium of information on the nature and utilization of exposure therapy in the treatment of anxiety disorders. The book is well written and thoughtfully organized, making it a worthy resource for practicing clinicians and a valuable guide for the training of health care professionals in the application of cognitive-behavioral interventions. (on the first edition)--PsycCRITIQUES, 12/14/2011ƒƒA comprehensive manual for clinicians detailing the application of exposure therapy in the treatment of a broad range of anxiety problems....The book serves not only as an evidence-based account of the model and rationale behind exposure therapy, but also as an aid to individualizing treatment according to patient nuances, whether overt or subtle....An invaluable source of reference for any clinician, regardless of experience level. (on the first edition)--Cognitive Behaviour Therapy, 10/3/2011

"An outstanding volume for providers, students, and researchers who want to understand not only what to do when conducting exposure therapy, but also how to do it, and why it works. The second edition integrates the latest research on the learning processes that are critical to making exposures work, and provides clear guidance on how to use the research findings to directly improve clinical practice. Clients treated by providers who have read this book should be in good hands!"--Bethany A. Teachman, PhD, Department of Psychology, University of Virginia

"This second edition remains the definitive book on exposure therapy for anxiety-related problems. It is comprehensive, clearly written, practical, and fully updated to reflect contemporary research and theory on exposure-based treatments. This book is an invaluable resource for novice and expert therapists alike, and it should be required reading for any student training in cognitive-behavioral therapy."--Martin M. Antony, PhD, ABPP, Department of Psychology, Toronto Metropolitan University, Canada

"The authors do an excellent job of dispelling therapists' common fears about implementing exposure therapy. They review the evidence base for the approach and separate facts from myths. Clinicians treating trauma may have concerns about retraumatizing patients; instead of dismissing these concerns, the authors validate them and provide solutions. I recommend this book as a 'must read' for clinicians at all levels of practice."--Johanna Kaplan, PhD, Director, Washington Anxiety Center of Capitol Hill, Washington, DC

“The authors do a splendid job of presenting the core clinical features that cut across all anxiety and trauma-related disorders. In so doing, they provide the reader a helpful heuristic for assisting in case formulation and treatment planning. Coverage of safety behaviors and their role in maintaining and exacerbating anxiety is particularly important, given that many clinicians still instruct anxiety patients to utilize safety behaviors to cope with their anxiety. I will assign this book as a required reading for my practicum course in evidence-based treatments."--Michael J. Telch, PhD, Professor of Psychology and Founding Director, Laboratory for the Study of Anxiety Disorders, The University of Texas at Austin

"Exposure has served as the treatment of choice for anxiety disorders for decades, despite many new therapies trying to take its mantle. Yet too many clinical practitioners either avoid using exposure or implement it suboptimally. Already the go-to resource on exposure therapy, this second edition elegantly balances the latest science and art of delivering this most effective therapy in the most effective manner."--Peter J. Norton, PhD, Cairnmillar Institute, Melbourne, Australia

"I have been training clinical psychology doctoral students in exposure-based CBT for all forms of anxiety for more than two decades, and have found this book to be invaluable in my advanced elective course on the topic. The authors are among the best in the field. The book has excellent coverage of the theory and science behind exposure, which is critical for my doctoral students to understand in order to implement the interventions successfully. There is also attention given to important 'in the trenches' issues for future clinicians. This is an outstanding graduate-level book."--Lisa Lilenfeld, PhD, Clinical Psychology Program, The Chicago School of Professional Psychology, Washington, DC -An invaluable reference and practical guide for new therapists and seasoned practitioners alike….The authors aptly revised their book in this second edition consistent with advances in research and the field's understanding of anxiety. Most notably, the authors moved to an inhibitory learning perspective from the emotional processing perspective that underscored the text's first edition….The book is a must-read for students and trainees as well as seasoned clinicians looking for a comprehensive, practical, readable text that is rooted in contemporary research….With numerous case examples and practical tips and recommendations, the expert authors do an excellent job increasing reader confidence in the application and benefit of utilizing therapeutic exposure in practice, while simultaneously dispelling common fears and concerns about exposure therapy.--Journal of Contemporary Psychotherapy, 9/1/2020ƒƒAn excellent compendium of information on the nature and utilization of exposure therapy in the treatment of anxiety disorders. The book is well written and thoughtfully organized, making it a worthy resource for practicing clinicians and a valuable guide for the training of health care professionals in the application of cognitive-behavioral interventions. (on the first edition)--PsycCRITIQUES, 12/14/2011ƒƒA comprehensive manual for clinicians detailing the application of exposure therapy in the treatment of a broad range of anxiety problems....The book serves not only as an evidence-based account of the model and rationale behind exposure therapy, but also as an aid to individualizing treatment according to patient nuances, whether overt or subtle....An invaluable source of reference for any clinician, regardless of experience level. (on the first edition)--Cognitive Behaviour Therapy, 10/3/2011