Web-Based Neuroscience Education to Improve Beliefs about Therapy for Anxiety-Related Disorders: Acceptability and Preliminary Efficacy (Preprint)

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BACKGROUND A major barrier to the success of psychotherapy, including exposure therapy for anxiety, is patients’ beliefs, such as their belief in their own ability (self-efficacy) to complete therapy and their belief that therapy will work (treatment expectancy). Randomized controlled studies indicate that teaching patients with chronic pain about how the brain processes and regulates pain improves these types of beliefs and substantially improves the outcome of physiotherapy for pain. However, the effect of neuroscience education in the context of psychotherapy for anxiety and other mental health disorders is largely unknown. OBJECTIVE We developed and evaluated a web-based neuroscience education add-on called NeuroEd, designed to enhance outcomes of exposure therapy for fear and anxiety, by boosting patients’ positive beliefs, particularly beliefs about exposure therapy. METHODS We developed brief NeuroEd videos on stress, fear, and exposure therapy, emphasizing neuroplasticity and how therapy can change the brain. In Study1, using the Prolific platform, we recruited 86 adults with probable anxiety. Half viewed 30 minutes of NeuroEd videos, and half viewed 30 minutes of Control videos on the same topics but without emphasis on the brain. Before and after the videos, both groups completed a survey on their beliefs (coping self-efficacy, treatment self-efficacy, treatment willingness, treatment expectancy, growth mindset, self-stigma of seeking psychotherapy, and self-compassion). After the videos, they also rated the acceptability of the videos and provided feedback on the videos. In Study2, we edited the videos according to the feedback and obtained responses on the new videos from 5 practicing clinicians (speech-language pathologists) and 12 clients receiving exposure-based therapy for speaking-related anxiety. RESULTS NeuroEd was acceptable by both the Prolific sample and the clients (e.g., useful, interesting, etc.) and by the clinicians (e.g., relevant, potentially impactful, etc.). In Study1, the two groups did not differ in any participant characteristics or baseline beliefs. NeuroEd increased all positive beliefs, including treatment self-efficacy (Hedges’ g=1.12) and treatment expectancy (g=1.09), as well as willingness to receive exposure therapy (g=0.78). NeuroEd outperformed Control on treatment self-efficacy (g=0.67) and growth mindset (g=0.66). In Study2, results were consistent with NeuroEd increasing clients’ treatment self-efficacy (g=0.65), treatment expectancy (g=0.64), and self-compassion (g=0.73). CONCLUSIONS This proof-of-concept study introduces NeuroEd as an acceptable and potentially efficacious tool to increase optimistic beliefs that underlie the success of psychotherapy. Future work may establish NeuroEd as a scalable novel tool to augment psychotherapy for anxiety, in the same way that neuroscience education has augmented physiotherapy for pain.

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