Mindful Emotion Awareness Facilitates Engagement with Exposure Therapy: An Idiographic Exploration Using Single Case Experimental Design.
Mindful emotion awareness before exposures helps some adults with social anxiety but not others—track each client’s data to decide.
01Research in Context
What this study did
Six adults with social anxiety got brief mindful emotion awareness training before their regular exposure sessions.
Each person worked on their own fear hierarchy while researchers tracked avoidance and distress minute-by-minute.
The team used single-case design so they could see how each individual responded instead of averaging everyone together.
What they found
Some people dropped their avoidance fast once they learned to notice feelings without judging them.
Others showed no change or even got more distressed when they paid close attention to anxiety.
The results were all over the map, which means the same add-on can help or hurt depending on the client.
How this fits with other research
Madsen et al. (1968) showed that feedback during exposure drives progress. Sasson et al. (2022) adds that tuning into feelings might replace external feedback for some clients.
Peters et al. (2013) got big wins with simple graduated exposure in preschoolers. The current study suggests adults may need more tailored add-ons since effects are less uniform.
Labrecque et al. (2006) used a full CBT package and saw steady gains. The mindfulness piece here could be a lighter first step before adding more complex skills.
Why it matters
You cannot assume mindful emotion awareness will help every client. Run a quick probe: add the training for three sessions, graph avoidance and distress each time, and keep it only if the data trend down. If scores climb or stay flat, drop the add-on and stick to standard exposure.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a two-minute mindful check-in before the first exposure trial, then graph avoidance and distress for three sessions to see if it helps that client.
02At a glance
03Original abstract
Exposure therapy works through inhibitory learning, whereby patients are exposed to stimuli that elicit anxiety in order to establish safety associations. Mindful emotion awareness, or nonjudgmental and present-focused attention toward emotions, may facilitate engagement in exposures, which may in turn enhance therapeutic outcome. This study utilizes a single-case experimental design (n = 6) to investigate the effect of mindful emotion awareness training on the use of avoidant strategies during exposures, distress during exposures, overall mindfulness, experiential avoidance, and symptom reduction in a sample of participants with social anxiety disorder. Data were analyzed using a combination of visual inspection and quantitative effect size metrics commonly applied in single-case experimental designs. To further investigate the relationship between distress and avoidant strategy use, contemporaneous and cross-lagged correlations were run. Results highlight individual differences in responses to mindful emotion awareness training and exposure exercises. Given these individual differences, repeated assessment and monitoring over the course of treatment may help clinicians most effectively identify treatment skills that will be most helpful for individual patients.
Behavior modification, 2022 · doi:10.1177/0145445520947662