Stakeholder Perceptions of the Barriers to Receiving and Delivering Exposure-Based Cognitive Behavioral Therapy for Anxiety Disorders in Adult Community Mental Health Settings

Abstract

CBT is considered the first-line treatment for anxiety disorders, particularly when it involves gradual confrontation with feared stimuli (i.e., exposure); however, delivery of CBT for anxiety disorders in real-world community clinics is lacking. This study utilized surveys we developed with key stakeholder feedback (patient, provider, and administrator) to assess patient and provider/administrator perceptions of the barriers to delivering (or receiving) CBT for anxiety disorders. Providers/administrators from two counties in California (N = 106) indicated lack of training/competency as primary barriers. Patients in one large county (N = 42) reported their own symptoms most often impacted treatment receipt. Both groups endorsed acceptability of exposure but indicated that its use in treatment provided/received had been limited. Implications and recommendations are discussed.

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Fig. 1

Notes

  1. 1.

    The decision to conduct patient focus groups at only two of the four clinics was purely practical. The funding for the qualitative and quantitative portions of the project was for 1 year, and recruiting patient participants required close logistical collaboration with the community partners. We chose the two clinics in which we believed timely recruitment would be most feasible.

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Correspondence to Kate Wolitzky-Taylor.

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This study was conducted in line with ethical guidelines for the conduct of human subjects research. It was approved by the Institutional Review Board. The authors have no disclosures or conflicts of interest.

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Wolitzky-Taylor, K., Chung, B., Bearman, S.K. et al. Stakeholder Perceptions of the Barriers to Receiving and Delivering Exposure-Based Cognitive Behavioral Therapy for Anxiety Disorders in Adult Community Mental Health Settings. Community Ment Health J 55, 83–99 (2019). https://doi.org/10.1007/s10597-018-0250-z

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Keywords

  • Anxiety disorders
  • Community mental health
  • Cognitive behavioral therapy
  • Community mental health