Table 1.
Similarities and Differences Between Inhibitory Learning-Based Exposures, Habituation-Based Exposures, and Behavioral Experiments in Cognitive Therapy
| Inhibitory learning-based exposures | Habituation-based exposures | Behavioral experiments in cognitive therapy | |
|---|---|---|---|
| Primary goal of exposures/experiments | Violation of expectancies | Within- and between-session habituation | Evaluate the validity of specific cognitions and/or beliefs |
| Purpose of exposures/experiments | Strengthen inhibitory extinction learning | Discontinue negative reinforcement cycle | Change dysfunctional cognitions and/or beliefs |
| Symptom hierarchy use in exposures/experiments | Symptom hierarchy developed to guide initial exposures and monitor progress | Development and strong adherence to a symptom hierarchy | Symptom hierarchy is not necessary for behavioral experiments |
| Gradation of exposure/experiments | Initial exposures can be graded, with variability in exposures introduced later in treatment | Exposures are traditionally systematically graded from least distressing to most distressing | Behavioral experiments are not graded in any particular order |
| Fear/anxiety/distress evoked by experiments/exposures | Exposures that evoke fear/anxiety/distress are important | Exposures that evoke fear/anxiety/distress are essential | Behavioral experiments that evoke fear/anxiety/distress are not essential |
| Frequency of exposures/experiments | Exposures conducted as many times as needed to violate expectancy | Exposures often repeated multiple times until habituation is achieved | Behavioral experiments are usually conducted only once |
| Duration of exposures/experiments | Exposures last until expectation is violated | Exposures last until habituation is reached, usually considered to be a 50% reduction in subjective distress | Behavioral experiments are typically brief in nature |
| Discontinuation of safety signals and safety signal behaviors | Discontinuation of safety signals and behaviors necessary | Discontinuation of safety signals and behaviors necessary | Discontinuation of safety signals and behaviors is irrelevant |