Impact of Switching to an Inhibitory Learning Approach to Exposure Therapy on Outcomes of an Intensive Outpatient Program.

Exposure therapy is a commonly used, efficacious treatment for reducing symptoms of obsessive-compulsive disorder and anxiety disorders. Though exposure therapy has primarily been conducted using principles derived from emotional processing theory, many researchers are now suggesting that it would be more successful if it was conducted in accordance with learning research (i.e., the inhibitory learning approach). There is a strong conceptual rationale for conducting exposure therapy in accordance with the inhibitory learning approach but a paucity of direct empirical comparisons of the two methods, particularly in a naturalistic setting. The current study includes 1968 participants seeking treatment for OCD and anxiety disorders. An interrupted time series analysis was used to compare treatment outcomes after participation in an intensive outpatient program for individuals who received exposure therapy based on emotional processing versus inhibitory learning. Symptom reduction following exposure therapy using the inhibitory learning approach was not significantly different than exposure therapy using emotional processing. One possible interpretation for these findings is that in practice, the exposure approaches share significant overlap and therefore lead to comparable outcomes. Future research should assess the comparative efficacy of these treatment approaches using randomized controlled trials with standardized outcome measures to increase internal validity.