The process of exposure: harnessing transformation through values and mindfulness

Background: Epidemiological studies have estimated a lifetime prevalence rate of 28.8% for anxiety disorders (Kessler et al, 2005), and a recent meta-analysis of 87 studies across 44 countries estimated the global current prevalence of anxiety disorders at 7.3% (4.8–10.9%, adjusted for methodological differences across studies; Baxter, Scott, Vos, & Whiteford, 2012). While exposure-based treatment for anxiety and OCD in youth and adult populations has robust empirical support, there is room for improvement. In terms of outcomes, intent-to-treat analyses suggest that approximately 1 in 5 individuals drop out of exposure treatment (Hofmann and Smits, 2008; Ong et al. 2016), and a significant of proportion of youth either do not improve or relapse (eg Ginsburg et al., 2013; 2018). Moreover, clinicians are unlikely to use exposure-based treatment even when it is needed (Freihart et al, 2004; Deacon et al., 2013; Sars & Van Minnen, 2015), due to their own experiential avoidance (Meyer…