Stakeholder Perceptions of the Barriers to Receiving and Delivering Exposure-Based Cognitive Behavioral Therapy for Anxiety Disorders in Adult Community Mental Health Settings

Community Ment Health J. 2019 Jan;55(1):83-99. doi: 10.1007/s10597-018-0250-z. Epub 2018 Mar 5.

Abstract

CBT is considered the first-line treatment for anxiety disorders, particularly when it involves gradual confrontation with feared stimuli (i.e., exposure); however, delivery of CBT for anxiety disorders in real-world community clinics is lacking. This study utilized surveys we developed with key stakeholder feedback (patient, provider, and administrator) to assess patient and provider/administrator perceptions of the barriers to delivering (or receiving) CBT for anxiety disorders. Providers/administrators from two counties in California (N = 106) indicated lack of training/competency as primary barriers. Patients in one large county (N = 42) reported their own symptoms most often impacted treatment receipt. Both groups endorsed acceptability of exposure but indicated that its use in treatment provided/received had been limited. Implications and recommendations are discussed.

Keywords: Anxiety disorders; Cognitive behavioral therapy; Community mental health.

MeSH terms

  • Adult
  • Anxiety Disorders / psychology*
  • Anxiety Disorders / therapy*
  • Clinical Competence / statistics & numerical data*
  • Cognitive Behavioral Therapy*
  • Community Mental Health Centers
  • Community-Based Participatory Research
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Services Accessibility
  • Humans
  • Interviews as Topic
  • Los Angeles
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care
  • Stakeholder Participation / psychology*
  • Surveys and Questionnaires