Anxiety disorders and related problems such as
obsessive-compulsive disorder (OCD) are among the most common mental health
conditions. While effective therapies for these often-debilitating disorders
exist, many sufferers find them very difficult to engage with or complete. This
prompted researchers at Concordia University in Montreal to look for ways to
make treatment easier to handle for those who need it most.
In studies recently published in the Journal
of Anxiety Disorders and forthcoming in Cognitive Behaviour Therapy,
Concordia psychology researchers Hannah Levy and Adam Radomsky show
that the very behaviours people use to avoid anxiety could become part of
an effective treatment, and that patients have a significant role to play in
deciding when those behaviours are no longer necessary.
Radomsky and Levy focus on safety behaviours—things
people do to make themselves feel less anxious. Examples include wearing gloves
when touching dirty objects, avoiding eye contact during stressful
interactions, distracting yourself when doing something scary—any behaviour
that increases feelings of safety in anxiety-provoking situations.
"Traditionally, psychologists thought
that fading out or eliminating these behaviours entirely should be the primary
focus of the therapy used
to combat anxiety
disorders. But we found that changing those behaviours and giving patients
greater agency is much more effective," says Radomsky, professor
in Concordia's Department of Psychology and senior author of the studies.
He and Levy followed 157 study
participants—ranging from people with low-level anxieties to those diagnosed
OCD—as they adapted old habits with new ones that they could use to avoid
anxiety during exposure therapy, in which the therapist exposes the patient to
feared objects or situations without any danger.
The researchers found that using new safety behaviours
during exposure
therapy was slightly more helpful to participants than their usual or
typical safety behaviours.
They also found that the most important aspect of
reducing the use of safety behaviours in therapy is that the client or patient
be the one who decides when they are ready to move forward without them.
"This is
different from the standard approach in which therapists encourage people to
drop their safety behaviours at the outset of the therapy, which often leads
people to drop out or refuse the treatment. Under the right
conditions, safety behaviours have the potential to make the therapy more
effective, and more acceptable," explains Levy, who recently defended her
PhD in psychology at Concordia and will graduate this summer.
Radomsky, who also holds a Concordia University
Research Chair in Anxiety and Related Disorders, says the results of the
research could help therapists shape their approach to best help each person
with whom they're working.
"It's our hope that these findings will help
to reduce the number of people who refuse or drop out of cognitive behavioural
therapies and should result in more people getting the help that they
need."

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