ABSTRACT

Exposure therapy is effective but widely underused. Numerous studies indicate therapist factors that might explain this pattern of underuse. This systematic review and meta-analysis synthesised those previous research findings, to identify which therapist factors are clearly associated with their intent to use exposure therapy. A systematic review and six random-effects meta-analyses synthesised studies identified in three databases (Scopus, PsychINFO, Web of Science) and through reference lists and citation searches. Most studies relied on a survey design, resulting in weak quality of research. Twenty-six eligible studies were included in the narrative synthesis, (including 5557 participants), while 21 studies yielded sufficient data to enter the meta-analysis. Medium to large pooled effect sizes indicated that therapists with more positive beliefs, a CBT orientation, and training in exposure therapy were significantly more likely to use exposure. Small pooled effect sizes indicated that older and more anxious therapists were less likely to use exposure. Therapist years of experience was not significantly associated with exposure use. There was no evidence of publication bias. Therapist characteristics clearly play a role in the use of exposure therapy, and future clinical and research work is required to address this limitation in the delivery of this effective therapy.

摘要

暴露疗法是有效的，但广泛未得到充分利用。大量研究表明治疗师因素可能解释这种使用不足的模式。这项系统回顾和荟萃分析综合了以前的研究结果，以确定哪些治疗师因素与他们使用暴露疗法的意图明显相关。系统综述和六项随机效应荟萃分析综合了三个数据库（Scopus、PsychINFO、Web of Science）以及通过参考文献列表和引文搜索确定的研究。大多数研究依赖于调查设计，导致研究质量较差。叙述综合中纳入了 26 项符合条件的研究（包括 5557 名参与者），而 21 项研究提供了足够的数据进入荟萃分析。中到大的汇总效应大小表明，具有更积极信念、CBT 取向和暴露疗法培训的治疗师更有可能使用暴露疗法。较小的汇总效应表明，年龄较大且焦虑的治疗师不太可能使用暴露疗法。治疗师的经验年数与暴露使用没有显着相关。没有证据表明存在发表偏倚。治疗师的特征显然在暴露疗法的使用中发挥着作用，需要未来的临床和研究工作来解决这种有效疗法的局限性。治疗师的经验年数与暴露使用没有显着相关。没有证据表明存在发表偏倚。治疗师的特征显然在暴露疗法的使用中发挥着作用，需要未来的临床和研究工作来解决这种有效疗法的局限性。治疗师的经验年数与暴露使用没有显着相关。没有证据表明存在发表偏倚。治疗师的特征显然在暴露疗法的使用中发挥着作用，需要未来的临床和研究工作来解决这种有效疗法的局限性。