Intervention techniques for specific phobias
DSM-IV-TR describes the central element of a specific phobia as excessive or unreasonable anxiety or fear related to a specific situation or object (APA, 2000). People with a specific phobia know that their fear is excessive or unreasonable. They work hard to avoid the feared stimulus, often significantly restricting their activity in the process.
Treatment of specific phobias generally targets one type of factor, although the beneficial changes affect all the factors. Neurological or psychological factors are usually the primary target of treatments.
Targeting Neurological Factors:
General belief appears to be that behavioral methods are the treatment of choice for specific phobias. Medication, such as benzodiazepine, may be prescribed, but this is generally not recommended. Preliminary Research Suggests that one medication (D-cycloserine, an antibiotic used to treat tuberculosis) may facilitate the neural basis of fear extinction; the combination of D-cycloserine and exposure is more effective than exposure alone (Ressler et al., 2004).
Targeting Psychological Factors:
Phobias are most treatable by CBT, with up to 90% lasting improvement rates even after only one session.
Behavioral method: Exposure
The behavioral method of graded exposure has proven effective in treating specific phobias and is considered a first-line treatment. With this method, the patient and therapists progress through an individualized hierarchy of anxiety-producing stimuli or events as fast as the patient can tolerate. Moreover, recent research on treating phobias with exposure suggests that virtual reality exposure works as well, at least for certain phobias.
Systematic desensitization and flooding have long been considered the primary intentions to treat phobias.
Cognitive methods for treating a specific phobia are similar to those used to treat other anxiety disorders. The therapist and patient identify illogical thoughts pertaining to the feared stimulus, and the therapist helps highlight discrepant information and challenges the patient to see the irrationality of these or her thoughts and expectations.
Targeting Social Factors - A limited role of observational learning:
Observational learning may play a role in the development of a specific phobia, but to many researchers’ surprise, seeing others model how to interact normally with the feared stimulus generally is not an effective treatment for specific phobias.