Systematic Review of the Clinical Application of Exposure Techniques to Community-Dwelling Older Adults with Anxiety.

ABSTRACT

OBJECTIVES: Although exposure techniques are a first-line intervention for anxiety, clear evidence is lacking for their efficacy in treating the prevalent and debilitating condition of late life anxiety. This study sought to review the current literature on use of exposure with community-dwelling older patients. METHODS: Searches of electronic databases were conducted to identify articles published through December 7, 2016. Inclusion criteria were 1) sample age > 55, 2) therapy that included exposure, 3) anxiety as a target of the treatment. Exclusion criteria were 1) not available in English, 2) no quantitative data, 3) inpatient setting. Methodological data and findings were extracted from the articles chosen for review. RESULTS: The 54 eligible articles presented a total of 16 case studies, 9 uncontrolled trials, 24 controlled trials, and 6 secondary studies. A majority of the studies were conducted in the U.S.A with participants who received individual treatment. In vivo and imaginal exposure were the most frequently delivered techniques, and most treatments were multicomponent. Most studies found a reduction in anxiety symptoms. CONCLUSIONS: Important research gaps need to be addressed. CLINICAL IMPLICATIONS The surveyed research provides a modest foundation of evidence for mental health practitioners who wish to incorporate exposure into treatment plans.