Abstract

Safety behaviour consists of actions, thoughts, and/or protective objects that fearful individuals use to reduce their anxiety. It can potentially interfere with the progress of exposure therapy, which entails exposing patients to a feared stimulus or situation, but other hypotheses suggest that it may not be entirely detrimental to treatment effectiveness. This study aims to elucidate the role of safety behaviour in exposure-based treatments for anxiety disorders and uses a paradigm of exposure treatment for snake fear. Participants are randomized to one of two conditions, whereby they use either safety gear, such as gloves and goggles, or do not use any safety gear during 45 minutes of systematic exposure to a live snake. Measures are administered pre-treatment, immediately following treatment, and 10 minutes post-treatment to assess participants' fear-related cognitions, subjective ratings of fear, and their distance of closest approach to the snake. The results demonstrate that exposure treatment for snake fear is effective irrespective of safety behaviour use, as indicated by pre- to post-treatment differences for both groups of participants on all outcome measures. It was found that participants who used safety gear reported cognitive change equivalent to those who did not use safety gear post-treatment, supporting the notion that use of safety behaviour during exposure treatment may promote adaptive cognitive change. Results are discussed in terms of cognitive-behavioural theories of and treatments for anxiety disorders.