Further Support for the Acceptability-Enhancing Roles of Safety Behavior and a Cognitive Rationale in Cognitive Behavioral Therapy for Anxiety Disorders

Abstract

It has been proposed that the judicious use of safety behavior may enhance the acceptability of cognitive behavioral therapy (CBT). Indeed, Milosevic and Radomsky (2013a) found that descriptions of CBT incorporating safety behavior were more acceptable than those that discouraged safety behavior. This study aimed to replicate and extend this work. Participants were 688 undergraduates who rated the acceptability of descriptions of CBT varying in safety behavior (judicious or discouraged) and rationale (cognitive or extinction). Consistent with Milosevic and Radomsky, CBT with safety behavior was significantly more acceptable than traditional CBT. Cognitively based CBT was preferred over extinction-based CBT. The effects of prior treatment and general distress were also examined. Overall, previous treatment and greater anxiety were associated with significantly lower acceptability ratings. Results support the acceptability-enhancing role of safety behavior in CBT and are discussed in terms of cognitive-behavioral theory and treatment of anxiety and related disorders.