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Anxiety

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Abstract

Similar to depression, anxiety is a significant public health problem with some estimates of prevalence as high as 28 % of the population. Cognitive behavioral therapy (CBT) has demonstrated both efficacy and effectiveness for the treatment of anxiety disorders, and is considered a frontline treatment. However, many consumers do not receive care at all or do not receive a sufficient dose of care. The authors provide a detailed analysis of systemic and individual barriers to receiving adequate treatment for anxiety and specify a number of simple, practical strategies to target the problem of under-engagement.

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References

  • Ahmed, M., & Westra, H. A. (2009). Impact of a treatment rationale on expectancy and engagement in cognitive behavioral therapy for social anxiety. Cognitive Therapy and Research, 33(3), 314–322. doi:10.1007/s10608-008-9182-1.

    Article  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Book  Google Scholar 

  • Antony, M. M., Orsillo, S. M., & Roemer, L. (Eds.). (2001). Practitioner’s guide to empirically based measures of anxiety. New York: Springer.

    Google Scholar 

  • Anxiety Disorders Association of Canada. (2003). Mental health and mental illness: Invited submission to the Standing Senate Committee on Social Affairs, Science, and Technology. Anxiety Disorders Association of Canada.

    Google Scholar 

  • Aviram, A., & Westra, H. A. (2011). The impact of motivational interviewing on resistance in cognitive behavioural therapy for generalized anxiety disorder. Psychotherapy Research, 21(6), 698–708. doi:10.1080/10503307.2011.610832.

    Article  PubMed  Google Scholar 

  • Bados, A., Balaguer, G., & Saldaña, C. (2007). The efficacy of cognitive–behavioral therapy and the problem of drop-out. Journal of Clinical Psychology, 63(6), 585–592. doi:10.1002/jclp.20368.

    Article  PubMed  Google Scholar 

  • Bakker, A., Van Balkom, A. J., & Spinhoven, P. (2002). SSRIs vs. TCAs in the treatment of panic disorder: A meta-analysis. Acta Psychiatrica Scandinavica, 106(3), 163–167. doi:10.1034/j.1600-0447.2002.02255.x.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.

    Google Scholar 

  • Becker, C. B., Zayfert, C., & Anderson, E. (2004). A survey of psychologists’ attitudes towards and utilization of exposure therapy for PTSD. Behaviour Research and Therapy, 42(3), 277–292. doi:10.1016/S0005-7967(03)00138-4.

    Article  PubMed  Google Scholar 

  • Bennett-Levy, J. (2003). Mechanisms of change in cognitive therapy: The case of automatic thought records and behavioural experiments. Behavioural and Cognitive Psychotherapy, 31(3), 261–277. doi:10.1017/S1352465803003035.

    Article  Google Scholar 

  • Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M., & Westbrook, D. (2004). Devising effective behavioural experiments. In K. Rouf, M. Fennell, D. Westbrook, M. Cooper, & J. Bennett-Levy (Eds.), Oxford guide to behavioural experiments in cognitive therapy (pp. 21–58). Oxford, UK: Oxford University Press.

    Chapter  Google Scholar 

  • Bieling, P., & Kuyken, W. (2003). Is cognitive case formulation science or science fiction. Clinical Psychology: Science and Practice, 10, 52–69.

    Google Scholar 

  • Bordin, E. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research, and Practice, 16, 252–260.

    Article  Google Scholar 

  • Brown, T. A., & Barlow, D. H. (2014). Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5)—Adult and lifetime version, clinican manual. Oxford, UK: Oxford University Press.

    Google Scholar 

  • Butler, A., Chapman, J., Forman, E., & Beck, A. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17–31. doi:10.1016/j.cpr.2005.07.003.

    Article  PubMed  Google Scholar 

  • Carroll, K. M. (1997). Enhancing retention in clinical trials of psychosocial treatments: Practical strategies. In L. S. Onken, J. D. Blaine, & J. J. Boren (Eds.), Beyond the therapeutic alliance: Keeping the drug-dependent individual in treamtent. Rockville, MD: NIDA Research monograph 165 (pp. 4–24).

    Google Scholar 

  • Casey, L. M., Oei, T. P. S., & Newcombe, P. A. (2005). Looking beyond the negatives: A time period analysis of positive cognitions, negative cognitions, and working alliance in cognitive-behavior therapy for panic disorder. Psychotherapy Research, 15(1–2), 55–68. doi:10.1080/10503300512331327038.

    Article  Google Scholar 

  • Chadwick, P., Williams, C., & Mackenzie, J. (2003). Impact of case formulation in cognitive behaviour therapy for psychosis. Behaviour Research and Therapy, 41(6), 671–680. doi:10.1016/S0005-7967(02)00033-5.

    Article  PubMed  Google Scholar 

  • Christon, L. M., McLeod, B. D., & Jensen-Doss, A. (2015). Evidence-based assessment meets evidence-based treatment: An approach to science-informed case conceptualization. Cognitive and Behavioral Practice, 22, 36–48. doi:10.1016/j.cbpra.2013.12.004.

    Article  Google Scholar 

  • Clark, D. A. (2013). Collaborative empiricism: A cognitive response to exposure reluctance and low distress tolerance. Cognitive and Behavioral Practice, 20(4), 445–454. doi:10.1016/j.cbpra.2012.06.001.

    Article  Google Scholar 

  • Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., … Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, null(01), 11–27. doi:10.1017/S0033291714000129.

  • Craske, M. G., Roy-Byrne, P., Stein, M. B., Sullivan, G., Hazlett-Stevens, H., Bystritsky, A., & Sherbourne, C. (2006). CBT intensity and outcome for panic disorder in a primary care setting. Behavior Therapy, 37(2), 112–119. doi:10.1016/j.beth.2005.05.003.

    Google Scholar 

  • Crits-Christoph, P., Connolly Gibbons, M. B., Crits-Christoph, K., Narducci, J., Schamburger, M., & Gallop, R. (2006). Can therapists be trained to improve their alliances? A preliminary study of alliance fostering psychotherapy. Psychotherapy Research, 16(3), 268–281. doi:10.1080/10503300500268557.

    Article  Google Scholar 

  • Crits-Christoph, P., Connolly Gibbons, M. B., Hamilton, J., Ring-Kurtz, S., & Gallop, R. (2011). The dependability of alliance assessments: The alliance–outcome correlation is larger than you might think. Journal of Consulting and Clinical Psychology, 79(3), 267–278. doi:10.1037/a0023668.

    Article  PubMed  PubMed Central  Google Scholar 

  • Deacon, B. J., Farrell, N. R., Kemp, J. J., Dixon, L. J., Sy, J. T., Zhang, A. R., & McGrath, P. B. (2013). Assessing therapist reservations about exposure therapy for anxiety disorders: The Therapist Beliefs about Exposure Scale. Journal of Anxiety Disorders, 27(8), 772–780. doi:10.1016/j.janxdis.2013.04.006.

    Google Scholar 

  • Deacon, B. J., Lickel, J. J., Farrell, N. R., Kemp, J. J., & Hipol, L. J. (2013). Therapist perceptions and delivery of interoceptive exposure for panic disorder. Journal of Anxiety Disorders, 27(2), 259–264. doi:10.1016/j.janxdis.2013.02.004.

    Article  PubMed  Google Scholar 

  • Deacon, B. J., Sy, J. T., Lickel, J. J., & Nelson, E. A. (2010). Does the judicious use of safety behaviors improve the efficacy and acceptability of exposure therapy for claustrophobic fear? Journal of Behavior Therapy and Experimental Psychiatry, 41(1), 71–80. doi:10.1016/j.jbtep.2009.10.004.

    Article  PubMed  Google Scholar 

  • Delsignore, A., Carraro, G., Mathier, F., Znoj, H., & Schnyder, U. (2008). Perceived responsibility for change as an outcome predictor in cognitive-behavioural group therapy. British Journal of Clinical Psychology, 47(3), 281–293. doi:10.1348/014466508X279486.

    Article  PubMed  Google Scholar 

  • Dozois, D. J. A., Westra, H. A., Collins, K. A., Fung, T. S., & Garry, J. K. F. (2004). Stages of change in anxiety: Psychometric properties of the University of Rhode Island Change Assessment (URICA) scale. Behaviour Research and Therapy, 42(6), 711–729. doi:10.1016/S0005-7967(03)00193-1.

    Article  PubMed  Google Scholar 

  • DuPont, R. L., Rice, D. P., Miller, L. S., Shiraki, S. S., Rowland, C. R., & Harwood, H. J. (1996). Economic costs of anxiety disorders. Anxiety, 2(4), 167–172. doi:10.1002/(SICI)1522-7154(1996)2:4<167::AID-ANXI2>3.0.CO;2-L.

    Article  PubMed  Google Scholar 

  • Farrell, N. R., Deacon, B. J., Dixon, L. J., & Lickel, J. J. (2013). Theory-based training strategies for modifying practitioner concerns about exposure therapy. Journal of Anxiety Disorders, 27(8), 781–787. doi:10.1016/j.janxdis.2013.09.003.

    Article  PubMed  Google Scholar 

  • Farrell, N. R., Deacon, B. J., Kemp, J. J., Dixon, L. J., & Sy, J. T. (2013). Do negative beliefs about exposure therapy cause its suboptimal delivery? An experimental investigation. Journal of Anxiety Disorders, 27(8), 763–771. doi:10.1016/j.janxdis.2013.03.007.

    Article  PubMed  Google Scholar 

  • Federoff, I. C., & Taylor, S. (2001). Psychological and pharmacological treatments of social phobia: A meta-analysis. Journal of Clinical Psychopharmacology, 21(3), 311–324.

    Article  Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (2002). Structured Clinical Interview for DSM-IV Axis I Disorders, research version, patient edition (SCID I/P). New York: Biometrics Research, New york State Psychiatric Interview.

    Google Scholar 

  • Fluckiger, C., Del Re, A. C., Wampold, B. E., Symonds, D., & Horvath, A. O. (2012). How central is the alliance in psychotherapy? A multilevel longitudinal meta-analysis? Journal of Counselling Psychology, 59(1), 10–17.

    Article  Google Scholar 

  • Foa, E. B., Liebowitz, M. R., Kozak, M. J., Davies, S., Campeas, R., Franklin, M. E., … Tu, X. (2005). Randomized, placebo-controlled trial of exposure and ritual prevention, Clomipramine, and their combination in the treatment of obsessive-compulsive disorder. American Journal of Psychiatry, 162(1), 151–161.

    Google Scholar 

  • Fontenelle, L., & Santana. (2011). A review of studies concerning treatment adherence of patients with anxiety disorders. Patient Preference and Adherence, 5, 427. doi:10.2147/PPA.S23439.

    Article  PubMed  PubMed Central  Google Scholar 

  • First, M. B., Wiliams, J. B. W., Karg, R. S., & Spitzer, R.L. (2015). User’s guide for the Structured Clinical Interview for DSM-5 Disorders (SCID-5). Arlington, VA: American Psychiatric Association.

    Google Scholar 

  • Gearing, R. E., Townsend, L., Elkins, J., El-Bassel, N., & Osterberg, L. (2014). Strategies to predict, measure, and improve psychosocial treatment adherence. Harvard Review of Psychiatry, 22(1), 31–45. doi:10.1097/HRP.10.1097/HRP.0000000000000005.

    Article  PubMed  Google Scholar 

  • Greenberg, P. E., Sisitsky, T., Kessler, R. C., Finkelstein, S. N., Berndt, E. R., Davidson, J. R., … Fyer, A. J. (1999). The economic burden of anxiety disorders in the 1990s. Journal of Clinical Psychiatry, 60(7), 427–435. doi:10.4088/JCP.v60n0702.

  • Grilo, C. M., Money, R., Barlow, D. H., Goddard, A. W., Gorman, J. M., Hofmann, S. G., … Woods, S. W. (1998). Pretreatment patient factors predicting attrition from a multicenter randomized controlled treatment study for panic disorder. Comprehensive Psychiatry, 39(6), 323–332. doi:10.1016/S0010-440X(98)90043-8.

  • Gulliver, A., Griffiths, K. M., Christensen, H., & Brewer, J. L. (2012). A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry, 12(1), 81.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry, 10(1), 113.

    Article  PubMed  PubMed Central  Google Scholar 

  • Harned, M. S., Dimeff, L. A., Woodcock, E. A., & Contreras, I. (2013). Predicting adoption of exposure therapy in a randomized controlled dissemination trial. Journal of Anxiety Disorders, 27(8), 754–762. doi:10.1016/j.janxdis.2013.02.006.

    Article  PubMed  Google Scholar 

  • Haug, T., Nordgreen, T., Öst, L. G., & Havik, O. E. (2012). Self-help treatment of anxiety disorders: A meta-analysis and meta-regression of effects and potential moderators. Clinical Psychology Review, 32(5), 425–445. doi:10.1016/j.cpr.2012.04.002.

    Article  PubMed  Google Scholar 

  • Heimberg, R. G., & Becker, R. E. (2002). Cognitive-behavioral group therapy for social phobia: Basic mechanisms and clinical strategies. New York: Guilford Press.

    Google Scholar 

  • Helbig-Lang, S., & Petermann, F. (2010). Tolerate or eliminate? A systematic review on the effects of safety behavior across anxiety disorders. Clinical Psychology: Science and Practice, 17(3), 218–233.

    Google Scholar 

  • Hembree, E. A., Foa, E. B., Dorfan, N. M., Street, G. P., Kowalski, J., & Tu, X. (2003). Do patients dropout prematurely from exposure therapy for PTSD? Journal of Traumatic Stress, 16(6), 555–562.

    Article  PubMed  Google Scholar 

  • Hood, H. K., Antony, M. M., Koerner, N., & Monson, C. M. (2010). Effects of safety behaviors on fear reduction during exposure. Behaviour Research and Therapy, 48(12), 1161–1169. doi:10.1016/j.brat.2010.08.006.

    Article  PubMed  Google Scholar 

  • Hunsley, J., Elliott, K., & Therrien, Z. (2013). The efficacy and effectiveness of psychological treatments. Ottawa, ON: Canadian Psychological Association.

    Google Scholar 

  • Huppert, J. D., Kivity, Y., Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2014). Therapist effects and the outcome–alliance correlation in cognitive behavioral therapy for panic disorder with agoraphobia. Behaviour Research and Therapy, 52, 26–34. doi:10.1016/j.brat.2013.11.001.

    Article  PubMed  Google Scholar 

  • Institute of Medicine. (2014). Treatment fo Posttraumatic Stress Disorder in military and veteran populations: Final assessment. Washington, DC: The National Academies Press.

    Google Scholar 

  • Issakidis, C., & Andrews, G. (2004). Pretreatment attrition and dropout in an outpatient clinic for anxiety disorders. Acta Psychiatrica Scandinavica, 109(6), 426–433. doi:10.1111/j.1600-0047.2004.00264.x.

    Article  PubMed  Google Scholar 

  • Katerelos, M., Hawley, L. L., Antony, M. M., & McCabe, R. E. (2008). The exposure hierarchy as a measure of progress and efficacy in the treatment of social anxiety disorder. Behavior Modification, 32(4), 504–518. doi:10.1177/0145445507309302.

    Article  PubMed  Google Scholar 

  • Keijsers, G. P. J., Kampman, M., & Hoogduin, C. A. L. (2001). Dropout prediction in cognitive behavior therapy for panic disorder. Behavior Therapy, 32(4), 739–749. doi:10.1016/S0005-7894(01)80018-6.

    Article  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62(6), 593–602. doi:10.1001/archpsyc.62.6.593.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627. doi:10.1001/archpsyc.62.6.617.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kim, E. J. (2005). The effect of decreased safety behaviours on anxiety and negative thoughts in social phobics. Anxiety Disorders, 19, 69–86.

    Article  Google Scholar 

  • Kobak, K. A., Greist, J. H., Jefferson, J. W., Katzelnick, D. J., & Henk, H. J. (1998). Behavioral versus pharmacological treatments of obsessive compulsive disorder: A meta-analysis. Psychopharmacology, 136(3), 205–216. doi:10.1007/s002130050558.

    Article  PubMed  Google Scholar 

  • Kohn, R., Saxena, S., Levav, I., & Saraceno, B. (2004). The treatment gap in mental health care. Bulletin of the World Health Organization, 82(11), 858–866. doi:10.1590/S0042-96862004001100011.

    PubMed  PubMed Central  Google Scholar 

  • Kuyken, W., Padesky, C. A., & Dudley, R. (2008). The science and practice of case conceptualization. Behavioural and Cognitive Psychotherapy, 36(Special Issue 06), 757–768. doi:10.1017/S1352465808004815.

    Article  Google Scholar 

  • Kuyken, W., Padesky, C., & Dudley, R. (2009). Collaborative case conceptualization: Working effectively with clients in cognitive-behavioral therapy. New York: Guilford Press.

    Google Scholar 

  • Lecrubier, Y. (2001). Prescribing patterns for depression and anxiety worldwide. Journal of Clinical Psychiatry, 62(Suppl. 13), 31–36.

    PubMed  Google Scholar 

  • Lepine, J. P. (2002). The epidemiology of anxiety disorders: Prevalence and societal costs. The Journal of Clinical Psychiatry, 63(Suppl. 14), 4–8.

    PubMed  Google Scholar 

  • Levy, H. C., & Radomsky, A. S. (2014). Safety behaviour enhances the acceptability of exposure. Cognitive Behaviour Therapy, 43(1), 83–92.

    Article  PubMed  Google Scholar 

  • Longmore, R. J., & Worrell, M. (2007). Do we need to challenge thoughts in cognitive behavior therapy? Clinical Psychology Review, 27(2), 173–187. doi:10.1016/j.cpr.2006.08.001.

    Article  PubMed  Google Scholar 

  • Lutz, W., Hofmann, S. G., Rubel, J., Boswell, J. F., Shear, M. K., Gorman, J. M., … Barlow, D. H. (2014). Patterns of early change and their relationship to outcome and early treatment termination in patients with panic disorder. Journal of Consulting and Clinical Psychology, 82(2), 287–297. doi:10.1037/a0035535.

    Google Scholar 

  • Maltby, N., & Tolin, D. F. (2005). A brief motivational intervention for treatment‐refusing OCD patients. Cognitive Behaviour Therapy, 34(3), 176–184. doi:10.1080/16506070510043741.

    Article  PubMed  Google Scholar 

  • McDonagh, A., Friedman, M., McHugo, G., Ford, J., Sengupta, A., Mueser, K., … Descamps, M. (2005). Randomized trial of cognitive-behavioral therapy for chronic posttraumatic stress disorder in adult female survivors of childhood sexual abuse. Journal of Consulting and Clinical Psychology, 73(3), 515–524. doi:10.1037/0022-006X.73.3.515.

    Google Scholar 

  • McLean, C. P., & Foa, E. B. (2013). Dissemination and implementation of prolonged exposure therapy for posttraumatic stress disorder. Journal of Anxiety Disorders, 27(8), 788–792. doi:10.1016/j.janxdis.2013.03.004.

    Article  PubMed  Google Scholar 

  • McManus, F., Van Doorn, K., & Yiend, J. (2012). Examining the effects of thought records and behavioral experiments in instigating belief change. Journal of Behavior Therapy and Experimental Psychiatry, 43(1), 540–547. doi:10.1016/j.jbtep.2011.07.003.

    Article  PubMed  Google Scholar 

  • McMillan, D., & Lee, R. (2010). A systematic review of behavioral experiments vs. exposure alone in the treatment of anxiety disorders. A case of exposure while wearing the emperor’s new clothes? Clinical Psychology Review, 30(5), 467–478. doi:10.1016/j.cpr.2010.01.003.

    Article  PubMed  Google Scholar 

  • Meyer, J. M., Farrell, N. R., Kemp, J. J., Blakey, S. M., & Deacon, B. J. (2014). Why do clinicians exclude anxious clients from exposure therapy? Behaviour Research and Therapy, 54, 49–53. doi:10.1016/j.brat.2014.01.004.

    Article  PubMed  Google Scholar 

  • Miller, W. R., & Rollnick, S. (2009). Ten things that motivational interviewing is not. Behavioural and Cognitive Psychotherapy, 37(02), 129–140. doi:10.1017/S1352465809005128.

    Article  PubMed  Google Scholar 

  • Milosevic, I., & Radomsky, A. S. (2013). Incorporating the judicious use of safety behavior into exposure-based treatments for anxiety disorders: a study of treatment acceptability. Journal of Cognitive Psychotherapy, 27(2), 155–174. doi:10.1891/0889-8391.27.2.155.

    Article  Google Scholar 

  • Mörtberg, E. (2014). Working alliance in individual and group cognitive therapy for social anxiety disorder. Psychiatry Research, 220(1–2), 716–718. doi:10.1016/j.psychres.2014.07.004.

    Article  PubMed  Google Scholar 

  • Moscovitch, D. A. (2009). What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioral Practice, 16(2), 123–134. doi:10.1016/j.cbpra.2008.04.002.

    Article  Google Scholar 

  • Mumma, G. H., & Smith, J. L. (2001). Cognitive–behavioral-interpersonal scenarios: Interformulator reliability and convergent validity. Journal of Psychopathology and Behavioral Assessment, 23(4), 203–221. doi:10.1023/A:1012738802126.

    Article  Google Scholar 

  • National Institute of Health and Clinical Excellence. (2011, January). Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults: Management in primary, secondary and community care. NICE.

    Google Scholar 

  • Norton, P. J., Klenck, S. C., & Barrera, T. L. (2010). Sudden gains during cognitive–behavioral group therapy for anxiety disorders. Journal of Anxiety Disorders, 24(8), 887–892. doi:10.1016/j.janxdis.2010.06.012.

    Article  PubMed  PubMed Central  Google Scholar 

  • Olatunji, B. O., Cisler, J. M., & Deacon, B. J. (2010). Efficacy of cognitive behavioral therapy for anxiety disorders: A review of meta-analytic findings. Psychiatric Clinics of North America, 33(3), 557–577.

    Article  PubMed  Google Scholar 

  • Otto, M. W., Reilly-Harrington, N. A., Kogan, J. N., & Winett, C. A. (2003). Treatment contracting in cognitive-behavior therapy. Cognitive and Behavioral Practice, 10(3), 199–203.

    Article  Google Scholar 

  • Ougrin, D. (2011). Efficacy of exposure versus cognitive therapy in anxiety disorders: Systematic review and meta-analysis. BMC Psychiatry, 11(1), 200.

    Article  PubMed  PubMed Central  Google Scholar 

  • Parrish, C., Radomsky, A., & Dugas, M. (2008). Anxiety-control strategies: Is there room for neutralization in successful exposure treatment? Clinical Psychology Review, 28(8), 1400–1412. doi:10.1016/j.cpr.2008.07.007.

    Article  PubMed  Google Scholar 

  • Persons, J. B., Beckner, V. L., & Tompkins, M. A. (2013). Testing case formulation hypotheses in psychotherapy: Two case examples. Cognitive and Behavioral Practice, 20(4), 399–409. doi:10.1016/j.cbpra.2013.03.004.

    Article  Google Scholar 

  • Price, M., & Anderson, P. L. (2012). Outcome expectancy as a predictor of treatment response in cognitive behavioral therapy for public speaking fears within social anxiety disorder. Psychotherapy, 49(2), 173–179. doi:10.1037/a0024734.

    Article  PubMed  Google Scholar 

  • Rachman, S., Radomsky, A. S., & Shafran, R. (2008). Safety behaviour: A reconsideration. Behaviour Research and Therapy, 46(2), 163–173. doi:10.1016/j.brat.2007.11.008.

    Article  PubMed  Google Scholar 

  • Radomsky, A. S., Shafran, R., Coughtrey, A. E., & Rachman, S. (2010). Cognitive-behavior therapy for compulsive checking in OCD. Cognitive and Behavioral Practice, 17(2), 119–131. doi:10.1016/j.cbpra.2009.10.002.

    Article  Google Scholar 

  • Ramnero, J., & Öst, L. G. (2007). Therapists’ and clients’ perception of each other and working alliance in the behavioral treatment of panic disorder and agoraphobia. Psychotherapy Research, 17(3), 320–328. doi:10.1080/10503300600650852.

    Article  Google Scholar 

  • Rowa, K., Gifford, S., McCabe, R., Milosevic, I., Antony, M. M., & Purdon, C. (2014). Treatment fears in anxiety disorders: Development and validation of the treatment ambivalence questionnaire: treatment fears in anxiety disorders. Journal of Clinical Psychology, 70(10), 979–993. doi:10.1002/jclp.22096.

    Article  PubMed  Google Scholar 

  • Ruzek, J. I., & Rosen, R. C. (2009). Disseminating evidence-based treatments for PTSD in organizational settings: A high priority focus area. Behaviour Research and Therapy, 47(11), 980–989. doi:10.1016/j.brat.2009.07.008.

    Article  PubMed  Google Scholar 

  • Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic: A cognitive account. Behavioural Psychotherapy, 19, 6–10.

    Article  Google Scholar 

  • Salkovskis, P. M., Hackmann, A., Wells, A., Gelder, M. G., & Clark, D. M. (2007). Belief disconfirmation versus habituation approaches to situational exposure in panic disorder with agoraphobia: A pilot study. Behaviour Research and Therapy, 45(5), 877–885. doi:10.1016/j.brat.2006.02.008.

    Article  PubMed  Google Scholar 

  • Schnurr, P. P., Friedman, M. J., Engel, C. C., Foa, E. B., Shea, M. T., Chow, B. K., … Bernardy, N. (2007). Cognitive behavioral therapy for posttraumatic stress disorder in women: A randomized controlled trial. JAMA, 297(8), 820–830.

    Google Scholar 

  • Spitzer, R. L., Kroenke, K., Williams, J. W., & and the Patient Health Questionnaire Primary Care Study Group. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. JAMA, 282(18), 1737–1744. doi:10.1001/jama.282.18.1737.

    Google Scholar 

  • Spitzer, R. L., Williams, J. B., Kroenke, K., Linzer, M., Verloin deGruy, F., Hahn, S. R., … Johnson, J. G. (1994). Utility of a new procedure for diagnosing mental disorders in primary care: The PRIME-MD 1000 study. Journal of the American Medical Association, 272(22), 1749–1756.

    Google Scholar 

  • Stangier, U., Heidenreich, T., Peitz, M., Lauterbach, W., & Clark, D. M. (2003). Cognitive therapy for social phobia: Individual versus group treatment. Behaviour Research and Therapy, 41(9), 991–1007. doi:10.1016/S0005-7967(02)00176-6.

    Article  PubMed  Google Scholar 

  • Stark, M., Campbell, B., & Brinkerhoff, C. (1990). “Hello, may we help you?” A study of attrition prevention at the time of the first phone contact with substance-abusing clients. American Journal of Drug and Alcohol Abuse, 16(2), 67–76. doi:10.3109/00952999009001573.

    Article  PubMed  Google Scholar 

  • Stecker, T., Fortney, J. C., & Sherbourne, C. D. (2011). An intervention to increase mental health treatment engagement among oif veterans: A pilot trial. Military Medicine, 176(6), 613–619.

    Article  PubMed  Google Scholar 

  • Sy, J. T., Dixon, L. J., Lickel, J. J., Nelson, E. A., & Deacon, B. J. (2011). Failure to replicate the deleterious effects of safety behaviors in exposure therapy. Behaviour Research and Therapy, 49(5), 305–314. doi:10.1016/j.brat.2011.02.005.

    Article  PubMed  Google Scholar 

  • Teasdale, J. D. (1999). Emotional processing, three modes of mind and the prevention of relapse in depression. Behaviour Research and Therapy, 37, S53–S77.

    Article  PubMed  Google Scholar 

  • Tolin, D. F. (2010). Is cognitive–behavioral therapy more effective than other therapies? A meta-analytic review. Clinical Psychology Review, 30(6), 710–720. doi:10.1016/j.cpr.2010.05.003.

    Article  PubMed  Google Scholar 

  • Tolin, D. F., Diefenbach, G. J., Maltby, N., & Hannan, S. (2005). Stepped care for obsessive-compulsive disorder: A pilot study. Cognitive and Behavioral Practice, 12(4), 403–414. doi:10.1016/S1077-7229(05)80068-9.

    Article  Google Scholar 

  • Tryon, G. S., & Winograd, G. (2011). Goal consensus and collaboration. Psychotherapy: Theory, Research, and Practice, 48(1), 50–57. doi:10.1037/a0022061.

    Article  Google Scholar 

  • Twomey, C., O’Reilly, G., Byrne, M., Bury, M., White, A., Kissane, S., … Clancy, N. (2014). A randomized controlled trial of the computerized CBT programme, MoodGYM, for public mental health service users waiting for interventions. British Journal of Clinical Psychology, 53(4), 433–450. doi:10.1111/bjc.12055.

    Google Scholar 

  • Van Apeldoorn, F. J., Stant, A. D., van Hout, W. J. P. J., Mersch, P. P. A., & den Boer, J. A. (2014). Cost-effectiveness of CBT, SSRI, and CBT+SSRI in the treatment for panic disorder. Acta Psychiatrica Scandinavica, 129(4), 286–295. doi:10.1111/acps.12169.

    Article  PubMed  Google Scholar 

  • Van Minnen, A., Hendriks, L., & Olff, M. (2010). When do trauma experts choose exposure therapy for PTSD patients? A controlled study of therapist and patient factors. Behaviour Research and Therapy, 48(4), 312–320. doi:10.1016/j.brat.2009.12.003.

    Article  PubMed  Google Scholar 

  • Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 603–613.

    Article  PubMed  Google Scholar 

  • Weiss, M., Kivity, Y., & Huppert, J. D. (2014). How does the therapeutic alliance develop throughout cognitive behavioral therapy for panic disorder? Sawtooth patterns, sudden gains, and stabilization. Psychotherapy Research, 24(3), 407–418. doi:10.1080/10503307.2013.868947.

    Article  PubMed  Google Scholar 

  • Westra, H. A. (2012). Motivational interviewing in the treatment of anxiety. New York: Guilford Press.

    Google Scholar 

  • Whittal, M. L., Robichaud, M., Thordarson, D. S., & McLean, P. D. (2008). Group and individual treatment of obsessive-compulsive disorder using cognitive therapy and exposure plus response prevention: A 2-year follow-up of two randomized trials. Journal of Consulting and Clinical Psychology, 76(6), 1003–1014. doi:10.1037/a0013076.

    Article  PubMed  Google Scholar 

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Correspondence to Allison J. Ouimet Ph.D. .

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Ouimet, A.J., Ashbaugh, A.R. (2017). Anxiety. In: O'Donohue, W., James, L., Snipes, C. (eds) Practical Strategies and Tools to Promote Treatment Engagement. Springer, Cham. https://doi.org/10.1007/978-3-319-49206-3_15

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