Investigating safety behavior effectiveness in exposure therapy in the reduction of negative feelings: raising commitment by means of a contract

Abstract

Background and objectives: Traditionally the practice of safety behaviors exercised by clients in vivo exposure has widely been regarded as impeding treatment. This view has been challenged by Rachman, Radomsky, Shafran and Zysk (2011). Healthy participants repeatedly touched a contaminant in two sessions, in which half of the participants engaged in safety behaviors (cleaning hands with hygienic wipe) while the other half did not. It was found that scores of contamination, fear, danger and disgust decreased in both sessions and the effects were not impeded by safety behaviors. This finding was critically replicated by van den Hout, Engelhard, Toffolo and van Uijen (2011), who obtained the same results. The current paper explicated on those findings by analyzing ‘commitment’ as a possible underlying condition which allow the use safety behaviors to work in therapy. Method: The van den Hout et al. (2011) study was replicated with 48 participants. Commitment was implemented by means of verbal emphasis as well as the signing of a contract. Results: No significant differences were found between commitment + and commitment – groups. Between SB+ and SB- it was found that rates of contamination in the former group dropped considerably faster than in the latter. Limitations: findings were obtained from a non-clinical sample. Conclusion: No therapeutic effect in the combination of safety behaviors and contracts was found. However, safety behaviors were once again shown to not impede therapy, falling in line with both Rachman et al. (2011) and van den Hout et al. (2011). More research is needed.