1 - (SYM 53) The Application of Exposure Principles to the Treatment of Depression

Abstract Body

Exposure-based cognitive therapy (EBCT) applies general principles of system change discovered in the science of complex adaptive systems, which are strikingly similar to principles of change in exposure-based therapies and modern learning theory. We will illustrate how principles of exposure can extend beyond anxiety and related disorders to treat depression within a cognitive-behavioral framework. EBCT targets three key mechanisms that maintain depression: 1) a negative thought loop of rumination and overgeneralization, 2) avoidance, and 3) a positive fizzle mechanism that interferes with the detection, processing, and ability to sustain positive emotion. EBCT is designed to release these lockdown mechanisms, destabilize maladaptive patterns, and facilitate emotional processing and new learning that can serve inhibitory functions. We describe the theoretical foundations of EBCT and then review important issues and adaptations to consider when applying exposure techniques to depression. We will briefly review research on the efficacy of EBCT in three open trials and a randomized controlled trial, as well as research on the process of change.