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For patients who completed the study, 86% in the exposure group improved on a measure that examined the frequency and severity of obsessions and compulsions compared with 48% in the clomipramine group and 79% in the combined-treatment group.
Several others have also demonstrated the efficacy of exposure-based treatments or treatment components for patients with GAD, so-cial anxiety disorder, and PTSD.
Internal vs external Exposures can target internal and/or external cues.
Exposures to external cues include a spider-phobic patient handling a spider, or a height-phobic patient systematically approaching increasing heights in a skyscraper.
Foa and colleagues randomized patients with OCD to receive in vivo exposure and response prevention, clomipramine, or a combination of both.For example, in the Harvard/Brown Anxiety Research Project, only 23% of treated patients reported receiving even occasional imaginal exposure and only 19% had received even occasional in vivo exposure.Another factor may be that many health care professionals do not understand the principles of exposure or may even hold (usually unfounded) negative beliefs about this form of treatment.Over a quarter of the people in the US population will have an anxiety disorder sometime during their lifetime, and available research literature suggests that exposure-based therapies should be considered the first-line treatment for these disorders.Although it is well established that exposure-based therapies are effective treatments for these disorders, however, only a small percentage of patients are actually treated with this approach.
Surveys of psychologists who treat patients with PTSD show that the majority do not use exposure therapy and most believe that exposure therapy is likely to exacerbate symptoms.