Perceived distress and endorsement for cognitive- or exposure-based treatments following trauma

This study investigated the perceived endorsement and distress, as judged by novice raters, of two therapies (cognitive and exposure therapy) in the treatment of post-traumatic stress disorder (PTSD) in a patient who had experienced a history of sexual abuse. It was found that novice raters perceived exposure as more distressing than cognitive therapy, and that endorsement of the two techniques was related to the outcome of the therapy rather than the therapy description. This provides support to the hypothesis that either a lack of knowledge or a priori beliefs of exposure therapy as a harsh intervention may cloud therapeutic interpretation and be one reason for the lack of widespread adoption of this effective intervention. These results suggest that behaviour therapists may need to educate the public/non-behaviour therapists regarding the sensitive application of behaviour modification strategies and educate new and practising clinicians regarding patient toleration of these therapies.