This is a Phase II Small Business Innovation Research (SBIR) grant application to support the further development of an innovative, online training program to aid in the dissemination of exposure therapies (ETs) for anxiety disorders. ETs have consistently and robustly been found effective in the treatment of anxiety disorders. However, these evidence-based treatments are rarely used in real world clinical settings and this appears to be due primarily to a lack of training in general exposure principles and procedures among clinical practitioners. The primary goal of this project is to facilitate the dissemination of ETs for anxiety disorders to treatment providers by completing an innovative foundational course online training (OLT) in exposure principles, techniques, and procedures commonly used in exposure therapies for anxiety disorders. The project contains three central aims: 1) to complete the development of the final OLT product using an iterative process that involves extensive feedback from target end-users and exposure experts throughout its development;2) to test the efficacy of the exposure online training course in a between subjects randomized controlled trial (RCT) using an additive design;and 3) to evaluate the relative merit of adding a Motivational Interviewing (MI) procedure involving two 20-minute interviews with subjects to determine if the addition of MI before starting and upon completing the OLT will positively impact outcomes. Exposure-naove treatment providers who have agreed to participate in the research will be randomly assigned to one of three condition: text (n=63), text+OLT (n=63), and text+OLT+MI (n=63). Subjects will be assessed at baseline, post-training, and at a 30 day and 60 day follow up. Major outcome variables will include: knowledge, self-efficacy, satisfaction, attitudinal change about exposure therapy, and engagement in further training in disorder-specific protocols (e.g., Panic Control Treatment for panic disorder). Additionally, subjects will complete two application based measures, including a performance-based role play. These therapy simulation measures will be conducted at baseline, post-test, and at the 60 day follow up.

Public Health Relevance

Anxiety disorders are the most common mental illness in the United States and are associated with significant personal, social, and economic costs. The vast majority of individuals with anxiety disorders receive no or inadequate treatment and this is due, in part, to a failure to disseminate evidence-based treatments to community mental health settings. Exposure therapies are highly effective, evidence-based treatments for anxiety disorders that may be readily transportable to community clinicians. This project aims to further develop an innovative online training of exposure principles and procedures to facilitate the dissemination of exposure therapies and improve clinical outcomes for individuals suffering from anxiety disorders.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
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Special Emphasis Panel (ZRG1-BBBP-D (11))
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Haim, Adam
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Behavioral Tech Research, Inc.
United States
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Harned, Melanie S; Dimeff, Linda A; Woodcock, Eric A et al. (2014) Exposing clinicians to exposure: a randomized controlled dissemination trial of exposure therapy for anxiety disorders. Behav Ther 45:731-44
Harned, Melanie S; Dimeff, Linda A; Woodcock, Eric A et al. (2013) Predicting adoption of exposure therapy in a randomized controlled dissemination trial. J Anxiety Disord 27:754-62