Exposure therapy consortium: Outcomes of the proof-of-principle study Background This paper reports on the outcomes of a proof-of-principle study for the Exposure Therapy Consortium, a global network of researchers and clinicians who work to improve the effectiveness and uptake of exposure therapy. The study aimed to test the feasibility of the consortium’s big-team science approach and test the hypothesis that adding post-exposure processing focused on enhancing threat reappraisal would enhance the efficacy of a one-session large-group interoceptive exposure therapy protocol for reducing anxiety sensitivity. Methods The study involved a multi-site cluster-randomized controlled trial comparing exposure with post-processing (ENHANCED), exposure without post-processing (STANDARD), and a stress management intervention (CONTROL) in students with elevated anxiety sensitivity. Feasibility was assessed using site performance metrics (e.g., timeline, sample size, missing data). Efficacy was assessed up to 1-month follow-up using the Anxiety Sensitivity Index-3. Results Despite challenges posed by unforeseen global crises, a standardized protocol for screening, assessment, and treatment at 12 research sites across four continents was successfully implemented, resulting in a total sample size of 400 with minimal missing data. Challenges in recruitment and adherence to the projected timelines were encountered. Significant reductions in anxiety sensitivity were observed in all conditions. Contrary to hypotheses, group differences were only observed at post-treatment, when ENHANCED and CONTROL outperformed STANDARD but were not significantly different from each other. Conclusions This study demonstrates the feasibility of the Exposure Therapy Consortium. Findings raise questions regarding the efficacy of large group exposure interventions and underscore the importance of careful research site selection and an iterative approach to treatment development. https://www.psych.uni-goettingen.de/de/translational/publikationen/exposure-therapy-consortium-outcomes-of-the-proof-of-principle-study https://www.psych.uni-goettingen.de/@@site-logo/university-of-goettingen-logo.svg

Jasper Smits, Jonathan Abramowitz, Rebecca Anderson, Joanna Arch, Daniel Badeja, Snir Barzilay, Amanda Belanger, Thomas Borchert, Emma Bryant, Alane Burger, Laura Dixon, Christina Dutcher, Hayley Fitzgerald, Bronwyn Graham, Anke Haberkamp, Stefan Hofmann, Jürgen Hoyer, Jonathan Huppert, David Johnson, Baraa Kabha, Alex Kirk, Jürgen Margraf, Peter McEvoy, Bryan McSpadden, Jill Newby, Michael Otto, Santiago Papini, E Parsons, Andre Pittig, Roxana Pittig, Winfried Rief, Svenja Schaumburg, Kiara Timpano, Lena Waltemate, Andre Wannemüller, Cornelia Weise and for the Exposure Therapy Consortium

Exposure therapy consortium: Outcomes of the proof-of-principle study

Journal of Anxiety Disorders

Abstract

Background This paper reports on the outcomes of a proof-of-principle study for the Exposure Therapy Consortium, a global network of researchers and clinicians who work to improve the effectiveness and uptake of exposure therapy. The study aimed to test the feasibility of the consortium’s big-team science approach and test the hypothesis that adding post-exposure processing focused on enhancing threat reappraisal would enhance the efficacy of a one-session large-group interoceptive exposure therapy protocol for reducing anxiety sensitivity. Methods The study involved a multi-site cluster-randomized controlled trial comparing exposure with post-processing (ENHANCED), exposure without post-processing (STANDARD), and a stress management intervention (CONTROL) in students with elevated anxiety sensitivity. Feasibility was assessed using site performance metrics (e.g., timeline, sample size, missing data). Efficacy was assessed up to 1-month follow-up using the Anxiety Sensitivity Index-3. Results Despite challenges posed by unforeseen global crises, a standardized protocol for screening, assessment, and treatment at 12 research sites across four continents was successfully implemented, resulting in a total sample size of 400 with minimal missing data. Challenges in recruitment and adherence to the projected timelines were encountered. Significant reductions in anxiety sensitivity were observed in all conditions. Contrary to hypotheses, group differences were only observed at post-treatment, when ENHANCED and CONTROL outperformed STANDARD but were not significantly different from each other. Conclusions This study demonstrates the feasibility of the Exposure Therapy Consortium. Findings raise questions regarding the efficacy of large group exposure interventions and underscore the importance of careful research site selection and an iterative approach to treatment development.