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ForwardJune 25, 2026: 15th Jack Green, M.D., Lecture in Psychiatry - Basal Exposure Therapy (BET) – Promoting Autonomy and Durable Change Through Exposure to Inner Phobias, Supported by Complementary External Regulation
Basal Exposure Therapy (BET) – Promoting Autonomy and Durable Change Through Exposure to Inner Phobias, Supported by Complementary External Regulation
Description:
BET is a diagnosis-independent treatment for individuals with severe and complex mental health challenges unresponsive to prior treatments. Their difficulties are understood as phobic avoidance of inner experience - most extremely, a fear of disintegrating, being engulfed, or becoming trapped in irresolvable pain. The core psychotherapeutic component is Basal Exposure (BE), an autonomy-based confrontation with the phobic object in which inhibitory learning generates disconfirming evidence that undermines catastrophic expectancies (Craske et al., 2022). BET is anchored in Complementary External Regulation (CER), a relational strategy and therapeutic stance that non-moralistically reallocates responsibility to patients, inviting and challenging them to abstain from behavioural dysregulation and engage in an autonomy-promoting psychotherapeutic process (Buchholz & Abramowitz, 2020). Therapist rotation supports generalization by providing multiple relational contexts that enhance variation and flexibility (Van Minnen et al., 2018).
This lecture addresses two critical gaps in mental health services. The first is the underestimation of experiential avoidance as a core process maintaining severe mental health difficulties: BET presents existential catastrophe anxiety as a key clinical phenomenon and demonstrates how shifting from avoidance to exposure and acceptance drives improvement across diagnostic categories. The second is the absence of effective strategies for reducing coercive measures and building a working alliance with the most challenging patients – a gap CER is designed to fill. Vestre Viken Hospital Trust has initiated the UID-BET project to improve clinical outcomes for this patient group and strengthen cost-effectiveness across its mental health services.
Target Audience
This program is intended for Psychiatrists, Psychologists, General and Family Practice Physicians, Psychiatric Nurses, Physician Assistants, Nurse Practitioners, and Social Workers.
Learning Objectives
Upon completion of the activity, participants will be able to:
- Explain the concept of the inner phobia in basal exposure therapy (BET).
- Describe the respective functions of Complementary External Regulation (CER) and basal exposure in BET.
- Describe the therapist’s role during exposure in BET.
SPEAKER(S)
Didrik Heggdal
Project Leader, The UID-BET Project at Vestre Viken Hospital Trust
Specialist in Clinical Psychology
Graduate Studies in Social Anthropology
Creator of Basal Exposure Therapy (BET) | Peer-Certified BET Therapist, Supervisor,
and Implementation Specialist |
Recipient, Norwegian Psychological Association Award, 2017
Didrik Heggdal
Didrik Heggdal is a clinical psychologist and project leader specializing in severe and difficult-to-treat mental health disorders, with a focus on exposure-based mechanisms of change. He is the founder and primary architect of Basal Exposure Therapy (BET), a diagnosis-independent, process-oriented treatment model for individuals with complex symptom presentations, entrenched avoidance, and longstanding functional impairment. His work integrates contextual behavioral science, affect-regulation theory, and experiential learning – including the systematic use of complementary external regulation (CER) to strengthen self-regulation and support deliberate engagement with avoided inner experience.
At Vestre Viken Hospital Trust, Heggdal leads the recently launched UID-BET project, which aims to design and establish a sustainable, cost-effective specialized service providing a coherent, autonomy-promoting continuum of care – from municipal services through outpatient, open inpatient, and closed inpatient settings. The project emphasizes coordinated collaboration across all levels of service, grounded in a holistic framework that prioritizes effective treatment pathways, adherence to the UN Convention on the Rights of Persons with Disabilities (CRPD), and rigorous cost-benefit considerations.
Heggdal has published internationally on BET and has presented at several international conferences across Europe and North America. His academic and clinical work advances scalable, mechanism-driven interventions for complex mental health conditions and develops models of durable therapeutic change for patient groups underserved by traditional psychiatric systems.
Disclosures: Speaker Fee: Bergen Municipality, Norway (Government/Public Institution); Author (Royalties): Abstrakt Forlag (Publishing Company), Gyldendal Forlag (Publishing Company)
Available Credit
- 1.00 AMA PRA Category 1 Credit™
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of IHP and Massachusetts General Hospital. IHP is accredited by the ACCME to provide continuing medical education for physicians.
IHP designates this Enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- 1.00 Nursing Contact Hours
Massachusetts General Laws, Chapter 13, sections 13, 14, 14A, 15 and 15D and Chapter 112, sections 74 through 81C authorize the Board of Registration in Nursing to regulate nursing practice and education.
This program meets the requirements of the Massachusetts Board of Registration in Nursing (244 CMR 5.00) for 1.00 contact hours of nursing continuing education credit. Advance practice nurses, please note: Educational activities which meet the requirements of the ACCME (such as this activity) count towards 50% of the nursing requirement for ANCC accreditation.
- 1.00 Social Workers
As a Jointly Accredited Organization, the MGH Institute of Health Professions is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. MGH Institute of Health Professions maintains responsibility for this course. Social workers completing this course receive 1.00 clock hours for continuing education credits.
- 1.00 Participation
This course allows other providers to claim a Participation Certificate upon successful completion of this course.
Participation Certificates will specify the title, location, type of activity, date of activity, and number of AMA PRA Category 1 Credit™ associated with the activity. Providers should check with their regulatory agencies to determine ways in which AMA PRA Category 1 Credit™ may or may not fulfill continuing education requirements. Providers should also consider saving copies of brochures, agenda, and other supporting documents.
- 1.00 Psychologists CE Credit
Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs. MGH Institute of Health Professions designates this activity for 1.00 CE credit.
Accreditation
In support of improving patient care, MGH Institute of Health Professions is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
1.0 Physicians
MGH Institute of Health Professions designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits ™. Physicians should claim only credit commensurate with the extent of their participation in this activity.
1.0 Physician Associates/Assistants
AAPA Credit Designation Statement – Live
MGH Institute of Health Professions has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation.
AAPA Credit Designation Statement – Enduring Materials
MGH Institute of Health Professions has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until {Expiration Date). PAs should only claim credit commensurate with the extent of their participation.
1.0 Nursing
MGH Institute of Health Professions designates this activity for 1.0 contact hours for nurses. The American Academy of Nurse Practitioners Certification Board (AANPCB) accepts credit from organizations accredited by the ACCME and ANCC.
1.0 Pharmacists
This activity provides 1.0 contact hours of continuing education credit.
NOTE FOR PHARMACISTS: Upon closing of the electronic evaluation, IHP will upload the pharmacy-related continuing education information to the CPE Monitor within 60 days. Per ACPE rules, IHP does not have access nor the ability to upload credits requested after the evaluation closes. It is the responsibility of the pharmacist or pharmacy technician to provide the correct information [NABP ePID and DOB (in MMDD format)] in order to receive credit for participating in a CE activity.
1.0 Psychologists:
Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs. MGH Institute of Health Professions designates this activity for 1.0 CE credit.
1.0 Social Workers
As a Jointly Accredited Organization, MGH Institute of Health Professions is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. MGH Institute of Health Professions maintains responsibility for this course. Social workers completing this course receive 1.0 clock hours for continuing education credits.
1.0 IPCE Credit
This activity was planned by and for the healthcare team, and learners will receive 1.0 Interprofessional Continuing Education (IPCE) credit for learning and change.