The Ethics and Experience of Brief Therapy: The Case of Exposure Therapy

Exposure therapy is a central component to successful cognitive-behavioral therapy (CBT) for anxiety disorders and can be effectively used to treat a wide range of anxiety disorders. As CBT interventions become more intensive and condensed, mental health professionals must consider the ethics of providing such treatment to youth, adolescents, and young adults. This chapter highlights the ethical considerations likely to arise with brief, intensive CBT interventions that often incorporate exposure. We review the six distinctive features of CBT that contribute to its efficacy, how such features apply to exposure therapy, and the ethical considerations associated with each feature. These CBT features (e.g., outside-of-session activities, emphasis on current experiences, providing patients with information about their treatment) have important implications for informed consent, avoiding harm, and maintaining confidentiality, boundaries, and treatment fidelity. Given that clinicians’ negative beliefs often stand in the way of providing effective treatment, the importance of assessing one’s own biases and competencies are also discussed. It is concluded that careful consideration and adherence to core ethical principles allows for the safe and effective delivery of brief, intensive CBT interventions.