It's the who not the when: An investigation of safety behavior fading in exposure to contamination

The judicious use of safety behavior may enhance the acceptability of exposure. However, practical questions concerning safety behavior fading remain. The current study compared the efficacy and acceptability of participant- and experimenter-initiated fading of safety behavior during exposure. Undergraduate students (N = 100) with subclinical contamination fear were assigned to complete an exposure session under one of three fading conditions: (1) participant-initiated (PI); (2) experimenter-initiated time (ET), in which the timing of safety behavior fading was yoked to the timing observed in PI; or (3) experimenter-initiated distress (ED), in which fading was based on subjective distress ratings. Compared to ET, PI demonstrated greater reductions in obsessive beliefs and peak fear, comparable changes in anticipatory fear and behavioral approach, and marginally higher expectancy ratings. PI and ED did not differ in outcome or acceptability. Results are discussed in terms of self-efficacy theory and the potential utility of safety behavior in exposure.