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Clinical practice

Maximizing Exposure Therapy: An Inhibitory Learning Approach

Craske, Treanor, Conway, Zbozinek & Vervliet (2014) · Behaviour Research and Therapy, 58

We use this paper in 12 places in the academy · 5 stated limits

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What the study found

Exposure works best when it proves a specific prediction wrong. You state what you expect and then test it. This works better than simply carrying on until the anxiety fades.

Dropping your safety behaviours on purpose, and practising in different conditions, produces learning that lasts longer than doing the feared thing carefully.

What works is repeated and varied exposure, with a clear prediction to prove wrong. The target number is our own way of organising it.

Exposure works best when it proves your fear wrong. When you act while you are afraid and the disaster does not come, your nervous system learns. When you wait to feel calm first, you mostly learn to wait.

See 3 more ways we describe the same finding

In the modern model of exposure therapy, you learn from the difference between what you feared and what actually happened. The authors include exposures that sometimes go badly among the methods that make the learning last.

Exposure produces learning that lasts longer when it proves a specific prediction wrong and varies the conditions. That works better than carefully enduring the feared situation until the anxiety fades.

Repeated and varied exposure, with a clear prediction to prove wrong, produces learning that lasts longer than doing the feared thing carefully once.

What the study cannot prove

The paper was written for exposure therapy given by a clinician to people in treatment. Applying it to practice on your own for ordinary shyness is our own step, and the paper says nothing about doing it alone.

Limits we note on the exercises

The popular “rejection therapy” challenges are stories, not evidence. The clinical part is the prediction and the review afterwards, not the stunt.

This was written for the treatment of anxiety disorders by clinicians. Applying it to a flat week at the gym is our own step.

The paper was written by clinicians for the treatment of anxiety disorders. Using it for one planned pause in a friendly conversation is our own step.

These are clinical exposure methods. Applying their schedule to social practice is our own step.

The target number is our own way of applying the principle. It is not a number from the paper.

Where we use it

We use this paper in 12 places in the academy. If the paper turned out to be wrong, we would have to change everything in this list. Some of the exercise instructions below are part of Gold. You can read every finding for free.

Other papers used in the same places

These papers are used in the same topics and videos as this one. That does not mean the papers agree with each other. It only means that the same exercises use both.

Clinical practice

A standard method that therapists use for fear. This is not therapy. It uses the same tools for everyday shyness.

You are free to read, link to and quote this page. If we claim more than this paper shows, please tell us at contact@suaviq.com. We read every correction, and corrections help us more than any other email.