Implications of a new theory of disuse for the treatment of emotional disorders

Abstract

In this review, we conceptualize exposure-based treat-ment as a learning experience. With this approach, op-timizing treatment is a matter of optimizing memory for new learning. Given that perspective, we discuss the implications of a "new theory of disuse, " proposed by Bjork and Bjork (1992) to capture the storage and retrieval dynamics that characterize human memory. The theory distinguishes between the storage strength and retrieval strength of learned representations and provides a framework from which we derive a number of manipulations that have the potential to improve the long-term effectiveness of Cognitive behavioral therapy. Implications for treatment of specific fears are de-scribed in detail, with additional discussion regarding treatment for other emotional disorders. Key words: behavior therapy, memory, fear. [Clin Psycho1 Sci Prac 6:8U-94, 19993 In the current health care climate, mental health profes-sionals are increasingly being asked to maximize effec-tiveness of interventions while minimizing cost. Exposure (i.e., repeated, systematic confrontation with a feared stimulus) has been established as the treatment of choice for clinical fear states (e.g., Barlow, 1988). Nonetheless, there is room for further improvement in treatment out-come, particularly in the long term. That is, despite the general appearance of maintenance of treatment gains after cognitive behavioral therapy for anxiety disorders

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