(PS1-94) Participant Satisfaction with an Online Exposure-based Cognitive Behavioral Intervention for Dental Anxiety

Nearly 20% of adults in the United States experience dental anxiety. Cognitive behavioral therapy (CBT) utilizing exposure-based paradigms are the gold standard treatments for anxiety disorders and specific phobias. However, many patients lack access to such specialized treatments, particularly in dental healthcare settings. We conducted a randomized controlled trial to determine whether a CBT intervention could be administered effectively by dental-trained staff (e.g., dental assistant) as compared to psychology-trained staff (e.g., post-doctoral psychology fellow). The present study explored participant satisfaction with the intervention and compared satisfaction ratings by interventionist type. Patients with dental anxiety were recruited from dental school clinics and, after providing signed informed consent, were randomized to one of three conditions: CBT with a dental assistant therapy aid, CBT with a psychology-trained aid, or a time- and attention-matched control group. The CBT intervention included an exposure-based fear hierarchy, such that participants ranked their three most feared dental procedures and were guided through a series of nine scenario-based exposure videos. For each of the feared procedures, participants viewed an informational video (least fear-inducing), a video from a third-person perspective of a patient undergoing the procedure (moderately fear-inducing), and a video from the first-person point of view of the procedure (most fear-inducing). Participants who completed the CBT intervention completed a satisfaction questionnaire following the intervention and at follow-up assessments. Mean satisfaction scores were examined, and t-tests assessed differences between the facilitator type (i.e., psychology-trained versus dental-trained). Analyses were conducted using SPSS.  A total of 499 participants (72% female, 62% Black, Mage=49) were enrolled in the clinical trial and randomized to the CBT intervention (n=335) or control condition (n=162). Participants who completed the CBT intervention rated the quality of the intervention as excellent (57%) or good (37%). Participants reported benefiting from the intervention, with 92% stating that the intervention helped them to deal with dental anxiety more effectively. Further, 92% reported that they received the type of treatment that they wanted and 98% said that they would recommend the dental anxiety treatment program to a friend. No significant differences were observed between intervention groups based on type of interventionist (p’s >.05). Interestingly, participants randomized to the dental-trained interventionists had higher ratings on several satisfaction items at one-month follow-up. At follow-up, the dental-trained group were more likely to say the intervention met their needs, t=3.29, p=.001, and they were satisfied with the amount of treatment they received, t=2.27, p=0.24, relative to the psychology-trained group. Adults with dental anxiety were highly satisfied with an online CBT intervention using an exposure paradigm. In settings where psychology-trained staff may not be available or feasible, dental staff can be trained to administer the intervention with equitable patient satisfaction.