Exposure Therapy for Youth Anxiety: A Qualitative Examination of Caregivers' Impressions

Many youth suffer from anxiety and related disorders yet do not receive adequate care. Exposure-based Cognitive Behavioral Therapy (CBT) is an effective evidence-based treatment for anxiety. Caregivers' understanding of exposure plays an important role in the decision to seek treatment. Data were qualitative interviews and surveys from caregivers (N = 36) of clinically anxious youth (aged 5-18). An integrated inductive and deductive thematic analysis approach was used to identify themes around perceptions of exposure. Caregivers liked the term exposure, finding it accurate. They praised exposure's effectiveness and appreciated therapists' facilitation. Concerns included short-term discomfort, challenges persevering through long-term treatment, difficulty doing exposures without a therapist, and variability in accessing treatment. Findings implicate dissemination efforts. Caregiver-facing materials should describe exposure in simple terms (e.g., slowly facing fears) and provide examples. Therapist training should counteract negative beliefs about exposure, model communication about exposure with families, and highlight the importance of caregiver involvement.