Individualisierte Exposition bei Angststörungen

Hardly any other psychotherapeutic intervention can be used as broadly as exposure. Absolute contraindications are very rare as an adaptation to assumed contraindications is possible in most cases. New approaches to exposure move away from the necessity of “habituation” and emphasize the role of threat expectancy violation and change. When planning and conducting exposure, therapists should first develop a hypothetical “ideal exercise” which has the maximum potential to violate the individual core threat expectancy. Afterwards, the best possible “optimal exercise” can be carried out based on the willingness of the patient and feasibility. By setting the focus of the exercise, special emphasis can be placed on habituation, threat expectancy violation, or other helpful experiences. Recent studies on this approach to exposure in anxiety disorders confirmed the very high and sustainable effectiveness and the role of threat expectancy change as the underlying mechanism.