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Behav Cogn Psychother. 2019 Mar;47(2):164-180. doi: 10.1017/S1352465818000371. Epub 2018 Jun 13.

The German Adaptation of the Therapist Beliefs about Exposure Scale: a Validation Study among Licensed Cognitive Behavioural Therapists in Germany.

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Division of Clinical Psychological Intervention,Freie Universit├Ąt Berlin,Berlin,Germany.



Exposure is an effective intervention in the treatment of pathological anxiety, but it is insufficiently disseminated. Therapists' negative attitudes towards exposure might be of relevance when considering factors contributing to the non-application of this intervention.


In order to be able to measure concerns in German-speaking therapist populations, the study aimed at validating a German version of the Therapist Beliefs about Exposure Scale.


The scale was translated into the German language and validated in a sample of 330 German licensed cognitive behavioural therapists.


In the present sample, the mean total score was significantly lower than in the original study including US-American therapists. Confirmatory factor analysis did not confirm the proposed one-factor model, while the exploratory factor analysis indicated that more than one factor is necessary to explain the structure of negative attitudes towards exposure. The internal consistency was high. Higher scores (more negative beliefs) were significantly correlated with older age, holding a master's degree (vs PhD), not being specialized in the treatment of anxiety disorders and with less experience with performance of exposure gained during clinical training. Negative beliefs about exposure were further associated with the self-reported average number of sessions spent on exposure in current treatment of post-traumatic stress disorder and panic disorder, and with negative attitudes towards application of exposure sessions presented in case vignettes.


The German adaptation provides the opportunity of measuring concerns regarding application of exposure in German-speaking therapist populations. However, the presented data reveal suggestions for further scale development.


anxiety disorders; cognitive behavioural therapy; dissemination; exposure; therapists

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