# Examining Behavioral Strategies for Enhancing Therapists' Delivery of Exposure Therapy

> **NIH NIH R34** · EMMA PENDLETON BRADLEY HOSPITAL · 2020 · $222,099

## Abstract

Project Summary/Abstract
Following decades of psychosocial treatment research the field has established numerous
evidence-based practices (EBPs) for mental disorders, but has struggled to widely disseminate
these practices in community settings. Exposure therapy for anxiety disorders represents one of
the most glaring examples of this research to practice gap. A well-known barrier to the
dissemination and quality delivery of exposure therapy is therapists’ negative beliefs about its
potential danger or intolerability for patients. These beliefs are common even among therapists
who report receiving specialized training; thus, research is needed to develop targeted training
strategies for reducing negative beliefs and improving delivery quality. Preliminary research
suggests specific behavioral strategies (i.e., self-exposure) may reduce negative beliefs above
and beyond standard didactic trainings (Farrell, Kemp et al., 2016). Building upon these
findings, we propose a novel experimental therapeutics approach to developing and testing a
targeted behavioral training for augmenting negative beliefs in a sample of community mental
health professionals. The first phase of the study is a case-series analysis for establishing
target engagement (i.e., belief reduction) and determining adequate dosing of the behavioral
strategies. Phase two is a randomized trial of the behaviorally-enhanced training strategies
(BeTS) against a standard didactic protocol. Therapist will complete a day-long workshop
followed by weekly consultation while delivering exposure for children with anxiety disorders.
The goal is to demonstrate increased effectiveness for the BeTS condition in reducing negative
beliefs during training and increasing the quality with which therapists deliver exposure. In-
session delivery behavior will be recorded and examined using a validated micro-analytic coding
system. This study will establish an innovative model for developing a targeted training
intervention capable of increasing the dissemination and quality of exposure therapy and other
EBPs.

## Key facts

- **NIH application ID:** 9846249
- **Project number:** 5R34MH118199-02
- **Recipient organization:** EMMA PENDLETON BRADLEY HOSPITAL
- **Principal Investigator:** Joshua Kemp
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $222,099
- **Award type:** 5
- **Project period:** 2019-03-01 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9846249

## Citation

> US National Institutes of Health, RePORTER application 9846249, Examining Behavioral Strategies for Enhancing Therapists' Delivery of Exposure Therapy (5R34MH118199-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9846249. Licensed CC0.

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