Habituation vs. Inhibitory Learning Exposure: A Comparison of Treatment Outcomes

Exposure therapy is a commonly used, efficacious treatment for reducing symptoms across anxiety disorders. Though exposure therapy has primarily been conducted using principles of emotional processing theory, many researchers are now suggesting that it would be more successful if it was conducted in accordance with learning research (i.e., the inhibitory learning approach). Currently, there are strong review papers highlighting the premise and proposed effectiveness of the inhibitory learning model, however, there is a dearth of empirical data supporting the superiority of this approach, particularly in a naturalistic setting. The current study includes 1,968 participants seeking treatment for OCD and other fear-based disorders. An interrupted time series analysis was used to compare treatment outcomes after participation in an intensive outpatient program for individuals who received emotional processing theory versus inhibitory learning approach exposure therapy. Symptom reduction following exposure therapy using the inhibitory learning approach was not significantly different than exposure therapy using emotional processing theory. Our results indicate that despite a stronger theoretical rationale supporting the inhibitory learning approach, symptom reduction was not significantly different between the two protocols. One possible interpretation for these findings is that in practice, the exposure models share significant overlap and therefore lead to comparable outcomes. Future research would benefit from further assessment of the two approaches in both naturalistic and laboratory settings.