Disorders - Specific Phobia
Koch, Ellen I., Spates, C., Himle, Joseph A.
This study evaluated the efficacy of behavioral and cognitive-behavioral one-session exposure treatment procedures with and without programmed generalization for participants with small animal phobias. Forty participants were randomly assigned to the treatment and generalization conditions. Both treatments produced significant improvements from pre-test to post-test and these results were maintained for 1 year. The treatment effect sizes ranged from large to very large across behavioral, self-report, and subjectively rated measures. Participants in the behavioral treatment condition reported that the treatment was significantly more intrusive than participants in the cognitive-behavioral treatment group. The programmed generalization condition did not produce additional measured benefit. The results are discussed in terms of the overall effectiveness of one-session exposure treatment components for small animal phobias. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (journal abstract).
Behaviour Research & Therapy, 42(12) : 1483-1504
- Year: 2004
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Exposure therapy, Exposure and response prevention
Waite, Wendy L., Holder, Mark D.
The effectiveness of the Emotional Freedom Technique (EFT), a treatment for anxiety and fear, was assessed. One hundred nineteen university students were assigned and tested in an independent four-group design. The groups differed in the treatment each received: applied treatment of EFT (Group EFT); a placebo treatment (Group P); a modeling treatment (Group M); and a control (Group C). Participants' self-reported baseline and post-treatment ratings of fear were measured. Group EFT showed a significant decrease in self-report measures at post-treatment. However, Group P and Group M showed a similar significant decrease. Group C did not show a significant decrease in post-treatment fear ratings. These results do not support the idea that the purported benefits of EFT are uniquely dependent on the "tapping of meridians." Rather, these results suggest that the reported effectiveness of EFT is attributable to characteristics it shares with more traditional therapies. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (journal abstract).
Scientific Review of Mental Health Practice, 2(1) : 20-26
- Year: 2003
- Problem: Specific Phobia
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Rentz, Timothy O., Powers, Mark B., Smits, Jasper A. J., Cougle, Jesse R., Telch, Michael J.
The aims of this study were to investigate exposure-based treatments for cynophobia (dog phobia) and to test a newly developed hybrid imaginal exposure treatment that we have named active imaginal exposure. The treatment introduces an in vivo coping component to imaginal exposure whereby the patient physically performs coping responses to an imagined feared stimulus. Eighty-two participants meeting DSM-IV criteria for specific phobia (animal subtype) were randomly assigned to one of three 30-min. treatments: (a) active-imaginal exposure (AI), (b) imaginal exposure alone (IE), or (c) graduated in vivo exposure (IV). Participants completed a behavioral approach test at pre, post, and four-week follow-up. Significant pre- to posttreatment improvement was observed in all three treatment conditions. Response rates at posttreatment were 51.9, 62.1, and 73.1% for the IE, AI, and IV groups respectively. Likewise, effect sizes at posttreatment were 0.76, 1.41, and 1.55 for the IE, AI, and IV groups respectively. Although in the predicted direction, the between group differences were not significant. A similar pattern of results was observed at follow-up. Further, safety behavior utilization during treatment was associated with less improvement--particularly in the two imaginal treatment conditions. Exposure treatments of dog phobia appear feasible and effective in reducing phobic fear and avoidance associated with dog phobia. Furthermore, preliminary evidence suggests that our active-imaginal exposure treatment may be a viable alternative to in vivo exposure.
Behaviour Research & Therapy, 41(11) : 1337-53
- Year: 2003
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention
Ost, Lars-Goran, Svensson, Lisa, Hellstrom, Kerstin, Lindwall, Robert
Sixty children, ages 7-17 years, who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnosis for various specific phobias were randomized to (a) 1-session exposure treatment alone, (b) 1-session treatment with a parent present, or (c) wait-list control group for 4 weeks. After the waiting period, the wait-list patients were rerandomized to the active treatments. The patients' phobias were assessed with behavioral approach tests (approach behavior, experienced anxiety, and physiological reactions), whereas general anxiety, depression, phobic tendencies, and anxiety sensitivity were assessed with self-report inventories. Assessments were done pre-, post-, and 1-year following treatment. Results showed that both treatment conditions did significantly better than the control condition, whereas the treatment groups did equally well on most measures, and the effects were maintained at follow-up. The implications of these results are discussed. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (journal abstract).
Journal of Consulting & Clinical Psychology, 69(5) : 814-824
- Year: 2001
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention
Dewis, L. M., Kirkby, K. C., Martin, F., Daniels, B. A., Gilroy, L. J., Menzies, R. G.
The efficacy of computer-aided vicarious exposure (CAVE) for the treatment of spider phobia in children was evaluated in a single blind, randomised, controlled trial. Twenty-eight participants, aged 10-17 years, received three 45-min sessions of either Live graded exposure (LGE), CAVE or were assigned to a Waitlist. Phobic symptomatology was measured at pre- and post-treatment, and at one month follow-up on a range of behavioural and subjective assessments. The results showed the superiority of the LGE treatment over the CAVE and Waitlist conditions. Effect sizes support CAVE treatment as being superior to the Waitlist and resulting in reductions of phobic symptomatology.
Journal of Behavior Therapy & Experimental Psychiatry, 32(1) : 17-27
- Year: 2001
- Problem: Anxiety Disorders (any), Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Silverman, W. K., Kurtines, W. M., Weems, C. F., Ginsburg, G. S., Rabian, B., Serafini, L. T.
This study evaluated the relative efficacy of an exposure-based contingency management (CM) treatment condition and an exposure-based cognitive self-control (SC) treatment condition relative to an education support (ES) control condition for treating children with phobic disorders. Eighty-one children and their parents completed a 10-week treatment program in which children and parents were seen in separate treatment sessions with the therapist, followed by a brief conjoint meeting. Children in both the CM and SC conditions showed substantial improvement on all of the outcome measures. These gains were maintained at 3-, 6-, and 12-month follow-ups. Interestingly, children in the ES condition also showed comparable improvements at posttreatment and at 3-, 6-, and 12-month follow-ups. Implications of the findings are discussed with respect to knowledge development and clinical practice.
Journal of Consulting & Clinical Psychology, 67(5) : 675-687
- Year: 1999
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Psychoeducation, Contingency management
Muris, P., Merckelbach, H., Holdrinet, I., Sijsenaar, M.
This study examined the efficacy of eye movement desensitization and reprocessing (EMDR) and exposure in the treatment of a specific phobia. Twenty-six spider phobic children were treated during 2 treatment phases. During the first phase, which lasted 2.5 hr, children were randomly assigned to either (a) an EMDR group (n = 9), (b) an exposure in vivo group (n = 9), or (c) a computerized exposure (control) group (n = 8). During the 2nd phase, all groups received a 1.5-hr session of exposure in vivo. Therapy outcome measures (i.e., self-reported fear and behavioral avoidance) were obtained before treatment, after Treatment Phase 1, and after Treatment Phase 2. Results showed that the 2.5-hr exposure in vivo session produced significant improvement on all outcome measures. In contrast, EMDR yielded a significant improvement on only self-reported spider fear. Computerized exposure produced nonsignificant improvement. Furthermore, no evidence was found to suggest that EMDR potentiates the efficacy of a subsequent exposure in vivo treatment. Exposure in vivo remains the treatment of choice for childhood spider phobia.
Journal of Consulting & Clinical Psychology, 66(1) : 193-198
- Year: 1998
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Eye movement desensitisation and reprocessing (EMDR)
, Exposure therapy, Exposure and response prevention
Last, C. G., Hansen, C., Franco, N.
Objective: To conduct a controlled group outcome investigation of the efficacy of cognitive-behavioral treatment for school phobia. Method: Fifty- six children with school phobia were randomly assigned to 12 weeks of cognitive-behavioral therapy or an attention-placebo control condition. Pre- and posttreatment school attendance, self-reported anxiety and depression, and diagnostic status were compared. Results: Both the experimental and control treatments were equally effective at returning children to school. Both treatments also were effective in reducing children's anxiety and depressive symptoms. Follow-up revealed no differences between groups when the children reentered school the next school year. Conclusions: Overall, results suggest that psychosocial treatments are effective at returning school-phobic children to school and that the highly structured cognitive- behavioral approach may not be superior to more traditional educational and supportive treatment methods.
Journal of the American Academy of Child & Adolescent Psychiatry., 37(4) : 404-411
- Year: 1998
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Muris, P., Merckelbach, H., VanHaaften, H., Mayer, B.
Background. Eye movement desensisation and reprocessing (EMDR) is a relatively new therapeutic technique that has been proposed as a treatment for post-traumatic stress disorder and other anxiety complaints. Method. We compared the efficacy of EMDR with that exposure in vivo in the treatment of a specific phobia. Twenty two spider-phobic children who met the DSM-III-R criteria for specific phobia participated in the study. Children were treated with one session of exposure in vivo and one session of EMDR in a crossover design. Treatment outcome was evaluated by self-report measures, a behavioural avoidance test and a physiological index (skin conductance level). Results. Results showed positive effects of EMDR, but also suggest that it is especially self-report measures that are sensitive to EMDR. Improvement on a behavioural measure was less pronounced, and exposure in vivo was found to be superior in reducing avoidance behaviour. With regard to skin conductance level, EMDR and exposure in vivo did not differ. Conclusions. EMDR has no additional value in treatment of this type of animal phobia, for which exposure in vivo is the treatment of choice.
British Journal of Psychiatry, 170(JULY) : 82-86
- Year: 1997
- Problem: Specific Phobia
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Eye movement desensitisation and reprocessing (EMDR)
, Exposure therapy, Exposure and response prevention
Rothbaum, B. O., Hodges, L. F., Kooper, R., Opdyke, D., Williford, J. S., North, M.
Objective: The authors' goal was to examine the efficacy of computer- generated (virtual reality) graded exposure in the treatment of acrophobia (fear of heights). Method: Twenty college students with acrophobia were randomly assigned to virtual reality graded exposure treatment (N=12) or to a waiting-list comparison group (N=8). Seventeen students completed the study. Sessions were conducted individually over 8 weeks. Outcome was assessed by using measures of anxiety, avoidance, attitudes, and distress associated with exposure to heights before and after treatment. Results: Significant differences between the students who completed the virtual reality treatment (N=10) and those on the waiting list (N=7) were found on all measures. The treatment group was significantly improved after 8 weeks, but the comparison group was unchanged. Conclusions: The authors conclude that treatment with virtual reality graded exposure was successful in reducing fear of heights.
American Journal of Psychiatry, 152(4) : 626-628
- Year: 1995
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Technology, interventions delivered using technology (e.g. online, SMS)
Ladouceur, R.
To determine whether cognitive treatment would enhance the effectiveness of participant modeling (PM) treatment for phobias, 36 subjects phobic to dogs and cats were given either PM alone, PM with self-instructional training, PM with self-verbalizations ('thinking aloud'), or placebo treatment. The three PM treatments produced substantial and equivalent improvement in behavior at posttest, in contrast to the placebo group, which did not change. At follow-up, the combined PM/self-instructional training group showed more phobic behavior and lower self-efficacy than the other PM groups.
Journal of Consulting & Clinical Psychology, 51(6) : 942-944
- Year: 1983
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions