title: The credibility of exposure therapy: Does the theoretical rationale matter?
abstract: OBJECTIVE
  Little is understood about how the public perceives exposure-based therapy (ET) for treating anxiety and trauma-related disorders or how ET rationales affect treatment credibility. Distinct approaches to framing ET are practiced, including those emphasized in traditional cognitive behavioral therapy, acceptance and commitment therapy, and the more recent inhibitory learning model. However, their relative effect on ET's credibility remains unknown.
  
  
  METHODS
  A final sample of 964 U.S. adults provided baseline views of ET. Participants rated ET treatment credibility following a simple ET definition (pre-rationale) and following randomization to rationale modules addressing ET goals, fear, and cognitive strategies from distinct theoretical perspectives (post-rationale). Baseline ET views, symptoms, and sociodemographic characteristics were examined as putative moderators and predictors.
  
  
  RESULTS
  At baseline, the majority had never heard of ET. From pre- to post-rationale, ET treatment credibility significantly increased but the rationales' theoretical perspective had little impact. More negative baseline ET views, specific ethnic/racial minority group status, and lower education moderated or predicted greater increases in treatment credibility following the rationale.
  
  
  CONCLUSIONS
  ET remains relatively unknown as a treatment for anxiety or trauma, supporting the need for direct-to-consumer marketing. Diverse theory-driven rationales similarly increased ET credibility, particularly among those less likely to use ET.
authors.affiliation: University of Colorado Boulder, Department of Psychology and Neuroscience, 345 UCB Muenzinger, Boulder, CO 80309-0345, United States. Electronic address: Joanna.Arch@Colorado.edu.
authors.forename: Joanna J
authors.initials: JJ
authors.lastname: Arch
authors.affiliation: Utah State University, Department of Psychology, 2810 Old Main Hill, Logan, UT 84322-2810, United States. Electronic address: Michael.Twohig@usu.edu.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Twohig
authors.affiliation: School of Psychology, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia. Electronic address: bdeacon@uow.edu.au.
authors.forename: Brett J
authors.initials: BJ
authors.lastname: Deacon
authors.affiliation: University of Colorado Boulder, Department of Psychology and Neuroscience, 345 UCB Muenzinger, Boulder, CO 80309-0345, United States. Electronic address: Lauren.Landy@colorado.edu.
authors.forename: Lauren N
authors.initials: LN
authors.lastname: Landy
authors.affiliation: Utah State University, Department of Psychology, 2810 Old Main Hill, Logan, UT 84322-2810, United States. Electronic address: ejbluett@aggiemail.usu.edu.
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Bluett
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D007171:Implosive Therapy; D008297:Male; D008389:Marketing of Health Services; D040921:Stress Disorders, Traumatic / Q000628:therapy*
keywords: Anxiety; Cognitive behavioral therapy; Direct marketing; Exposure; Treatment