Published Measures
Note: Dr. Deacon grants unrestricted permission to any interested parties to use these measures for any purpose. Science is meant to be open!
Broken Leg Exception Scale PDF
Source: Meyer, J. M., Farrell, N. R., Kemp, J. J., Blakey, S. M., & Deacon, B. J. (2014). Why do clinicians exclude anxious clients from exposure therapy? Behaviour Research and Therapy, 54, 49-53. PDF
Description: The BLES measures client characteristics that cause clinicians to exclude them from exposure therapy for anxiety. The scale asks respondents to rate the likelihood that they would exclude a client from exposure therapy for anxiety for each of 25 reasons on a 4-point scale from 0 ("Very unlikely to exclude from exposure therapy based on this characteristic") to 3 ("Very likely to exclude from exposure therapy based on this characteristic"). Higher scores represent a greater tendency to exclude clients from exposure therapy for anxiety, most/all of which are arguably not empirically supported reasons for excluding eligible clients from exposure.
Scoring: A total score is calculated by summing responses to each item.
Use/population: Assessing reasons for excluding anxious clients from exposure therapy among mental health clinicians.
Psychometrics: Adequate item-level statistics, total score normally distributed, excellent internal consistency (alpha = .93).
Validity: Significant positive correlations with negative beliefs about exposure therapy and anxiety sensitivity among clinicians.
Note: Dr. Deacon grants unrestricted permission to any interested parties to use these measures for any purpose. Science is meant to be open!
Broken Leg Exception Scale PDF
Source: Meyer, J. M., Farrell, N. R., Kemp, J. J., Blakey, S. M., & Deacon, B. J. (2014). Why do clinicians exclude anxious clients from exposure therapy? Behaviour Research and Therapy, 54, 49-53. PDF
Description: The BLES measures client characteristics that cause clinicians to exclude them from exposure therapy for anxiety. The scale asks respondents to rate the likelihood that they would exclude a client from exposure therapy for anxiety for each of 25 reasons on a 4-point scale from 0 ("Very unlikely to exclude from exposure therapy based on this characteristic") to 3 ("Very likely to exclude from exposure therapy based on this characteristic"). Higher scores represent a greater tendency to exclude clients from exposure therapy for anxiety, most/all of which are arguably not empirically supported reasons for excluding eligible clients from exposure.
Scoring: A total score is calculated by summing responses to each item.
Use/population: Assessing reasons for excluding anxious clients from exposure therapy among mental health clinicians.
Psychometrics: Adequate item-level statistics, total score normally distributed, excellent internal consistency (alpha = .93).
Validity: Significant positive correlations with negative beliefs about exposure therapy and anxiety sensitivity among clinicians.
Contamination Cognitions Scale PDF PERSIAN TRANSLATION
Sources: Deacon, B. J., & Olatunji. B. O. (2007). Specificity of disgust sensitivity in the prediction of behavioral avoidance in contamination fear. Behaviour Research and Therapy, 45, 2110-2120. PDF
Description: The CCS measures the tendency to overestimate the likelihood and severity of contamination. The scale presents respondents with a list of 13 objects often associated with germs and asks participants to imagine what would happen if they touch each object and are unable to wash their hands afterwards. For each object, participants provide two ratings: the likelihood that touching the object would result in contamination, and ‘‘how bad it would be’’ if they were actually contaminated. Ratings are given on a 0–100 scale, where 0 = ‘‘not at all likely,’’ 50 = "moderately likely,’’ and 100 = ‘‘extremely likely’’ (likelihood ratings) and 0 = ‘‘not at all bad,’’ 50 = ‘‘moderately bad,’’ and 100 = ‘‘extremely bad’’ (severity ratings). Higher scores represent higher contamination-related threat overestimation.
Scoring: A total score is calculated by averaging scores across likelihood and severity ratings for each item. Separate subscale scores may be created for likelihood and severity ratings but they are correlated at r = .83, so a total score is also appropriate. In the study above, only the total score was used.
Use/population: Assessing contamination-related threat overestimation in adults.
Psychometrics: Excellent internal consistency (alphas = .95 to .98); excellent one-week test-retest reliability (alpha = .94).
Validity: Significant, moderate correlations with measures of disgust sensitivity, anxiety and avoidance during a contamination-related behavioural avoidance task (Deacon & Olatunji, 2007); scores increased significantly following a contamination-related safety behaviour manipulation (Deacon & Maack 2008).
Exposure Therapy Case Vignette PDF
Sources: Study 2 in Deacon, B. J., Farrell, N. R., Kemp, J. J., Dixon, L. J., Sy, J. T., Zhang, A. R., & McGrath, P. B. (2013). Assessing therapist reservations about exposure therapy for anxiety disorders: The Therapist Beliefs about Exposure Scale. Journal of Anxiety Disorders, 27, 772-780. PDF; Farrell, N. R., Kemp, J. J., Blakey, S. M., Meyer, J. M., & Deacon, B. J. (2016). Targeting clinician concerns about exposure therapy: A pilot study comparing standard vs. enhanced training. Behaviour Research and Therapy, 85, 53-59. PDF
Description: This measure walks the respondent sequentially through the delivery of an exposure therapy session with a hypothetical 39-year-old woman diagnosed with OCD. Participants choose an item from an exposure hierarchy and are subsequently asked to describe behaviours used at various points during the session. The scale provides an overall measure of the degree to which clinicians deliver exposure therapy in a more or less cautious manner.
Scoring: The “Distress Reduction” scale (12 items; alphą=.90) sums responses to the following therapist actions across all time points: (a) use of arousal reduction strategies, (b) reassurance of safety, (c) selecting an easier exposure item, and (d) terminating the exposure. The “Intense Delivery” scale (11 items; alphą = .84) sums the following therapist actions across all time points: (a) encouraging continued contact with the object, (b) reiterating the treatment rationale and benefits of exposure, and (c) increasing intensity by increasing contact with the object. The “Safety Behavior Acquiescence” scale (9 items; alphą = .93) sums responses across the last three time points denoting acquiescence to client requests to touch the exposure item only with fingertips, use hand sanitiser, and wipe hands on pants. Farrell et al. (2016) calculated a "overall delivery" total score to assess overall quality of exposure therapy delivery.
Use/population: Assessing the quality of exposure therapy delivery among current or future therapists, particularly the tendency of therapists to deliver exposure in a cautious vs. confident manner.
Psychometrics: Internal consistency (alphas) for each sub scale and total score are good-to-excellent (.84 to .93).
Validity: Significant, moderate-to-strong associations with negative beliefs about exposure therapy; significant reductions following exposure therapy training workshop.
Shy Bladder Scale PDF
Source: Deacon, B. J., Lickel, J. J., Abramowitz, J. S., & McGrath, P. B. (2012). Development and validation of the shy bladder scale. Cognitive Behaviour Therapy, 41, 251-260. PDF
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Therapist Beliefs about Exposure Scale PDF GERMAN TRANSLATION (Japanese translation currently underway by Dr. Takashi Mitamura's research team)
Source: Deacon, B. J., Farrell, N. R., Kemp, J. J., Dixon, L. J., Sy, J. T., Zhang, A. R., & McGrath, P. B. (2013). Assessing therapist reservations about exposure therapy for anxiety disorders: The Therapist Beliefs about Exposure Scale. Journal of Anxiety Disorders, 27, 772-780. PDF
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