Which of the following treatments is most frequently used to eliminate specific phobias?

Most people will feel some degree of anxiety and discomfort when they anticipate a painful experience, such as getting an injection, or when faced with potential danger, such as being confronted by an angry, barking dog.

People with a specific phobia, however, have developed an extreme fear of a particular object, activity or situation which is out of proportion with the actual level of threat posed. People with specific phobia will actively avoid the feared object or situation, and experience a high level of anxiety if it is encountered.1,2

Common phobias include:

• animal related phobias (e.g., snakes, spiders, dogs)
• phobias relating to the natural environment (e.g., storms, water)
• blood, injection, and injury phobias (e.g., needles, medical procedures)
• situational phobias (e.g., elevators, aeroplanes, tunnels).1,2

Specific phobias usually develop during childhood and they are twice as likely to be diagnosed in women compared to men. Over 75 per cent of people with a specific phobia experience multiple phobias over their lifetime.3

Symptoms

Specific phobia is characterised by:

• an intense fear or anxiety related to a specific object, activity or situation which is out of proportion with the degree of danger actually posed
• active efforts to avoid the feared object, activity or situation (e.g., taking the stairs to avoid going in an elevator).1,2

A diagnosis of specific phobia is made when these symptoms are present for six months or longer and cause the person significant distress, or interfere with important aspects of the person’s life, such their work or relationships.1,2

Causes

While many phobias have no obvious cause, a number of factors have been linked to the development of a specific phobia. These include:

• Genetic factors: People with a family history of animal phobias, situational phobias, and blood, injection, and injury phobias have a higher chance of developing the phobia than those without a family history.4
• Direct learning: Many phobias (especially those related to animals, injections, and enclosed-spaces) occur following a negative experience, for example, a person may develop a phobia of dogs after having been bitten by a dog.5

• Indirect learning: A person may become fearful of a particular object or situation after observing another person’s fearful response to that same object or situation.5

Once a specific phobia has developed, a person’s continued experience of fear is thought to occur due to a number of behavioural and cognitive factors (see diagram below). These include:

• Unhelpful thoughts: Unhelpful thoughts such as overestimating the chance of harm or incorrect beliefs about the consequences of confronting a feared object/situation are also thought to contribute to the continued experience of a phobia.7,8

• Avoidance: Avoidance is a common behavioural reaction to a specific phobia as it allows people to avoid feelings of fear and anxiety. However, avoidance prevents opportunities to learn to challenge fearful beliefs and develop effective coping skills to manage anxiety. As a result the specific phobia is maintained and not overcome.6

Treatment

Exposure therapy

Exposure therapy is considered the most effective treatment for specific phobias.9 In exposure therapy, the person confronts the feared object or situation without engaging in any avoidance or escape behaviours. By encouraging people to face their fears, it is thought that exposure therapy teaches a person that feelings of anxiety decrease naturally over time and that the feared consequences of the phobic object or situation are unlikely to occur.6

The most effective form of exposure therapy is in vivo exposure.9 In vivo exposure is typically conducted in a controlled environment and involves directly confronting the person’s fear through a series of activities which provoke increasing levels of fear and anxiety. For example, a person with a phobia of dogs may first decide to approach a dog on a leash, then proceed to pat a dog on the head, then allow a dog to lick his/her hand, and eventually go to a dog park. A person usually undergoes exposure therapy until the most anxiety-provoking situation has been successfully mastered.6,10

Cognitive therapy

Cognitive therapy involves helping the person to identify and challenge unhelpful thoughts. This technique might be used alone or in conjunction with exposure therapy.9,11

Seeking help

If a specific phobia is affecting your day-to-day life, a psychologist may be able to help. Psychologists are highly trained and qualified professionals, skilled in diagnosing and treating a range of mental health concerns, including phobias. A psychologist can help you to identify and manage the factors that contribute to your anxiety.

Psychologists usually see clients individually, but can also include family members to support treatment where appropriate. Psychologists sometimes offer group therapy, involving a small number of people with similar issues.

If you are referred to a psychologist by your GP, you might be eligible for a Medicare rebate. Ask your psychologist or GP for details.

There are number of ways to access a psychologist. You can:

• use the Australia-wide Find A PsychologistTM directory or call 1800 333 497
• ask your GP or another health professional to refer you.

References

1. American Psychiatric Association. (2013).Diagnostic and Statistical Manual of Mental Disorders(5th ed.). Washington DC: Author.
2. World Health Organization. (2008).ICD-10: International Statistical Classification of Diseases and Related Health Problems (10th Rev.). New York, NY: Author.
3. LeBeau, R. T., Glenn, D., Liao, B., Wittchen, H.-U., Beesdo-Baum, K., Ollendick, T., & Craske, M. G. (2010). Specific phobia: A review of DSM-IV specific phobia and preliminary recommendations for DSM-V.Depression and Anxiety, 27(2), 148-167. doi: http://dx.doi.org/10.1002/da.20655
4. Van Houtem, C. M. H. H., Laine, M. L., Boomsma, D. I., Ligthart, L., van Wijk, A. J., & De Jongh, A. (2013). A review and meta-analysis of the heritability of specific phobia subtypes and corresponding fears.Journal of Anxiety Disorders, 27(4), 379-388. doi: http://dx.doi.org/10.1016/j.janxdis.2013.04.007
5. Hofmann, S. G., Alpers, G. W., & Pauli, P. (2008). Phenomenology of panic and phobic disorders. In M. M. Antony & M. B. Stein (Eds.),Oxford handbook of anxiety and related disorders(pp. 34-46). New York, NY: Oxford University Press,.
6. Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. H. (2011).Exposure therapy for anxiety: Principles and practice. New York, NY: Guilford Press.
7. Hood, H. K., & Antony, M. M. (2012). Evidence-based assessment and treatment of specific phobias in adults. In T. E. Davis III, T. H. Ollendick & L-G. Öst (Eds.),Intensive one-session treatment of specific phobias(pp. 19-42). New York, NY: Springer Science + Business Media.
8. McCabe, R. E., Ashbaugh, A. R., & Antony, M. M. (2010). Specific and social phobia. In M. M. Antony & D. H. Barlow (Eds.),Handbook of assessment and treatment planning for psychological disorders(2nd ed., pp. 186-223). New York, NY: Guilford Press.
9. Wolitzky-Taylor, K. B., Horowitz, J. D., Powers, M. B., & Telch, M. J. (2008). Psychological approaches in the treatment of specific phobias: A meta-analysis.Clinical Psychology Review, 28(6), 1021-1037. doi: http://dx.doi.org/10.1016/j.cpr.2008.02.007
10. Cisler, J., Lohr, J., Sawchuk, C., & Olatunji, B. (2010). Specific Phobia. In J. C Thomas & M. Hersen (Eds.),Handbook of Clinical Psychology Competencies(pp. 697-722). New York: Springer
11. Choy, Y., Fyer, A. J., & Lipsitz, J. D. (2007). Treatment of specific phobia in adults.Clinical Psychology Review, 27(3), 266-286. doi: http://dx.doi.org/10.1016/j.cpr.2006.10.002

Find a Psychologist™

Access thousands of psychologists across Australia

Search near me

Which of the following assessment tools is least likely to be used by a psychoanalytically oriented psychologist?

Which of the following is a possible reason why cats can see better at night than humans?

Which of the following forms of therapy most likely involves a confrontational atmosphere between the therapist and the client?

Which type of psychologist would be interested primarily in studying whether people behave differently in groups than they do when along group of answer choices?