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A Preliminary Exploration of the Barriers to Delivering (and Receiving) Exposure-Based Cognitive Behavioral Therapy for Anxiety Disorders in Adult Community Mental Health Settings

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Abstract

Despite the effectiveness of exposure-based cognitive behavioral therapy (CBT) for anxiety disorders, few individuals in need receive this treatment, particularly in community mental health settings serving low-income adults. The present study took a preliminary step to understand these barriers by conducting a series of key informant interviews and focus groups among patients, providers, clinical administrators, and policy makers. Several themes emerged as barriers to the delivery of exposure-based CBT in these settings, including therapist training and compentency issues, logistical issues, and funding stream issues. Clinical implications and future research that can build from these data are discussed.

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Notes

  1. We include posttraumatic stress disorder (PTSD) in our conceptualization of anxiety disorders, but refer to “anxiety disorders and PTSD” as “anxiety disorders” throughout, for the sake of parsimony.

  2. In order to preserve confidentiality of participants, clinic names are not provided but are identified by geographic region in Table 1.

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Funding

Funding was provided by National Center for Advancement of Translational Sciences (Grant No. UL1TR000124).

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Authors and Affiliations

  1. Department of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, USA

    Kate Wolitzky-Taylor, Jason Grossman, Jeanne Miranda & Bowen Chung

  2. Department of Social Work, University of Southern California, Los Angeles, USA

    Karissa Fenwick & Rebecca Lengnick-Hall

  3. Department of Educational Psychology, University of Texas at Austin, Austin, USA

    Sarah Kate Bearman

  4. Department of Psychology and Neuroscience, University of Colorado-Boulder, Boulder, USA

    Joanna Arch

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  1. Kate Wolitzky-Taylor
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  2. Karissa Fenwick
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  3. Rebecca Lengnick-Hall
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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.

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Wolitzky-Taylor, K., Fenwick, K., Lengnick-Hall, R. et al. A Preliminary Exploration of the Barriers to Delivering (and Receiving) Exposure-Based Cognitive Behavioral Therapy for Anxiety Disorders in Adult Community Mental Health Settings. Community Ment Health J 54, 899–911 (2018). https://doi.org/10.1007/s10597-018-0252-x

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