A Review of the Research Supporting (and Not Supporting) Inhibitory Learning Strategies

In my posts about exposure therapy, I’ve written about inhibitory learning theory a bit. I’ve particularly focused on how inhibitory learning theory has supplanted emotional processing theory (EPT) as the best supported model for exposure.

I recently came across a thorough review article that walks through the major inhibitory learning principles and recommended procedures—as well as some not explicitly tied to inhibitory learning –and assess the degree to which these principles and strategies are supported by research to date

The authors conclude:

Collectively, research support for exposure augmentation techniques aimed at optimizing inhibitory learning has fallen short of theoretical expectation in several respects. Though the literature strongly suggests that this theory provides a better mechanistic explanation for the results of exposure therapy than alternatives such as EPT (at least as originally proposed), findings regarding particular enhancement strategies have been quite inconsistent; even among studies in support of specific techniques, the majority of effects are modest at best.

As a summary can’t do justice to this article, I recommend you check it out yourself. If you have any interest in exposure therapy, it is essential reading.

Weisman, J.S, & Rodebaugh, T.L. (2018). Exposure therapy augmentation: A review and extension of techniques informed by an inhibitory learning approach. Clinical Psychology Review, 59, 41-51.

Here’s a link to the author’s ResearchGate page, where you can request a copy of the article.

UPCOMING TRAINING EVENTS

January 31, 2020, 8:30 am – 4:30 pm · Portland, OR · Details

This workshop is intended to be part 1 of a two day workshop, but can also be taken on its own. This workshop is useful for therapists who want an update on the current clinically applicable research on how shame functions, including an overview of how and when shame tends to be adaptive versus maladaptive. This day has two primary goals: 1. To provide an overview of research on shame and self-criticism that can guide clinical practice and 2. To allow therapists to experience the model from the inside-out so as to develop greater personal self-compassion and a deeper intuitive understanding of compassion-based intervention strategies. Read more

February 1, 2020, 8:30 am – 4:30 pm · Portland, OR · Details

This workshop is intended to be part 2 of a two day workshop, but can also be taken on its own. If you already have a thorough understanding of the functions of shame and a good understanding of Acceptance and Commitment Therapy, then it is you will probably be OK taking just the second day of this workshop. The workshop proceeds to discuss how ACT processes can be focused on addressing chronic and pervasive shame-based difficulties, with a particular focus on flexible perspective taking. Demonstrations of how to use perspective taking and compassion-fostering strategies with clients will be provided and attendees will also practice in small groups. An overview of chair work in the context of ACT will be provided. Read more

February 29, 2020, 9:00 am – 12:15 pm · Portland, OR · Details

Exposure is one of most the effective treatments for anxiety, trauma, and obsessive compulsive and related disorders (e.g., OCD, PTSD, panic disorder). A transdiagnostic intervention, exposure involves the repeated and systematic engagement with avoided stimuli that cause anxiety. Unfortunately, exposure remains underutilized by clinicians (e.g., Scherr, Herbert, & Forman, 2015), mostly due to misunderstandings of how exposure works and perceived difficulty of using it with clients. This half-day workshop will address these gaps by drawing from research on enhancing clinician understanding of and ways to overcome barriers to delivering exposure therapy (Farrell et al., 2016). Using didactics, role-play, and experiential exercises, participants will learn flexible application of exposure for a variety of clinical targets. Read more

April 17 and 18, 2020, 9:15 am – 5:00 pm · Portland, OR · Details

Do you ever “get stuck” as a therapist? Do some of your clients press your “hot buttons”? Do you ever find yourself struggling and thinking about “what do I do next” or feeling anxious, scared or stressed in therapy? In this workshop we will work on clarifying your therapist values and defining what is “difficult” about “difficult” clients. Through discussions, demonstrations and roleplays we will then work on these difficult clients and look at the processes from a compassionate ACT perspective. Read more