Does patient reluctance towards exposure and psychologists' attitudes about evidence based practice influence treatment recommendations for panic disorder? An experimental investigation

- Patient reluctance in a vignette reduces use of evidence based interventions.
- Psychologist attitudes towards evidence associated with emphasis on research.
- Training could identify how reluctance to exposure could be a treatment target.

This study examined the effects of patient reluctance towards exposure on practitioners' subsequent treatment recommendations. Participants (N = 236) were doctoral level psychologists who received a vignette of a patient with panic disorder, which either did (experimental group) or did not (control group) mention patient reluctance towards exposure. Evidence Based Practice (EBP) attitudes were also assessed and taken into account. A significant main effect of reluctance, averaged across all levels of EBP attitudes, and theoretical orientations was obtained (OR = 2.85, 95% CI = [1.51, 5.39], p = 0.001, RR = 1.46), with controls 1.46 times more likely to recommend exposure. A significant main effect of EBP attitudes was also obtained (p < 0.001). The odds of recommending exposure increased by 11% with each increase of positive EBP attitudes, across both levels of patient reluctance and theoretical orientation.