PSYCHOLOGY STUDY LINE

Effective Treatments for Specific Phobia
Specific phobias are the only anxiety disorder for which psychological treatments are almost always considered to be the best approach to treatment. There are no controlled studies showing that medications are an effective treatment for specific phobias.
Psychological Treatments
• Exposure to Feared Situations – This technique, also called in vivo exposure , is the treatment of choice for specific phobias. Essentially, it involves confronting a feared situation repeatedly, until the situation no longer triggers fear. For example, someone with a fear of spiders might begin treatment by looking at pictures of spiders, or by standing 30 feet away from a spider in a sealed jar and gradually moving closer and closer to the spider (eventually even touching it). Someone with a fear of storms might be taught to stand near the window or on the front porch during a storm, instead of hiding in the basement. Someone with a fear of elevators would be taught to ride elevators repeatedly until the fear decreases. Exposure works best when it occurs frequently (e.g., several times per week), and lasts long enough for the fear to decrease (up to two hours). Exposure-based treatments for some specific phobias (e.g., animals, blood) have been shown to work in as little as one session.
• Applied Muscle Tension – This technique is used specifically to treat people with blood and needle phobias who have a history of fainting in the situation (see the “Did you know….” section below). It combines exposure to blood and needles with exercises that involve tensing all of the muscles of the body, which temporarily raises the person’s blood pressure and prevents fainting.
• Cognitive Therapy – Involves learning to identify one’s anxious thoughts and to replace them with more realistic thoughts. For example, an individual who is convinced that an airplane will crash might be encouraged to consider the evidence supporting that belief. In reality, the odds of a commercial flight crashing are about one in ten million, and the most dangerous part of any flight is the drive to the airport! Note that cognitive therapy alone is generally not considered an appropriate treatment for a specific phobia. However, some individuals may benefit from using cognitive strategies along with repeated exposure to feared situations.
Biological Treatments
There is very little research on the use of medications to treat specific phobias, and most experts believe that medications are not an appropriate form of treatment for this problem. Still, some individuals with specific phobias (especially those from the situational type, e.g., flying, driving) report some benefit from using either selective serotonin reuptake inhibitors, such as paroxetine (Paxil) and similar medications, or anti-anxiety medications such as diazepam (Valium) and related drugs. However, for long term improvement, medications are no substitute for behavioral treatments such as exposure. There is probably little benefit gained over the long term from combining medications with behavioral treatments for specific phobia.