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3 - CBT for Specific Phobias

from Part One - Cognitive Behavioral Therapy for Anxiety Disorders

Published online by Cambridge University Press:  06 January 2022

Gillian Todd
Affiliation:
University of East Anglia
Rhena Branch
Affiliation:
University of East Anglia
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Summary

Although fear can protect us from harm and prepare us for danger, disproportionately extreme fear can turn into a specific phobia when it leads to extreme avoidance of and distress in feared situations, thereby interfering with our lives and mental well-being. This chapter gives instructions and examples of how an assessment and mini formulation for specific phobias can help to construct a ‘fear hierarchy’ and to understand which ‘safety behaviors’ can maintain phobias. With case illustrations, the chapter describes how to apply exposure therapy, the cornerstone CBT method for specific phobias, in which an individual gradually confronts each trigger in the fear hierarchy while refraining from safety behaviors. The chapter also outlines how to overcome common difficulties with exposure therapy and how to measure therapy outcomes. Finally, cognitive restructuring is discussed as a CBT approach for specific phobias in which exposure-based activities are used to test and challenge exaggerated or unhelpful ideas about feared situations.

Type
Chapter
Information
Evidence-Based Treatment for Anxiety Disorders and Depression
A Cognitive Behavioral Therapy Compendium
, pp. 29 - 49
Publisher: Cambridge University Press
Print publication year: 2022

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References

Further Recommended Reading

This is the definitive guide on CBT for specific phobias. The first part of

the book gives an extensive background on the phenomenology and

assessment of specific phobias; it also gives an overview of the evidence

for various treatments for specific phobias. The second part of the book

focuses on one-session treatment for specific phobias with adults and

children. It gives detailed instructions and treatment plans and materials

on how to conduct one-session treatments. The last part of the book

addresses special topics in CBT for specific phobias, including how to

train therapists and assess their competence, how to adapt the treatment

for specialist populations (e.g., people with learning or developmental

difficulties), ethical issues, research evidence, and use of technologies.

Davis, T. E. III., Ollendick, T. H., & Ost, L. G. (2012). Intensive one-session treatment of specific phobias. Springer-Verlag.Google Scholar
Öst, L.‐G., & Reuterskiöld, L. (2013). Specific phobias. In Gregoris, S. & Hofmann, S. G. (Eds.), CBT for anxiety disorders: A practitioner book (pp. 107133). Wiley Online Publishing.CrossRefGoogle Scholar

References

Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. H. (2011). Exposure therapy for anxiety: Principles and practice. Gilford PressGoogle Scholar
Ayala, E. S., Meuret, A. E., & Ritz, T. (2009). Treatments for blood-injury-injection phobia: A critical review of current evidence. Journal of Psychiatric Research, 43(15):12351242.CrossRefGoogle ScholarPubMed
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. International Universities Press.Google Scholar
Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M., & Westbrook, D. (Eds). (2004). Oxford guide to behavioural experiments in cognitive therapy. Oxford University Press.Google Scholar
Blakey, S. M., & Abramowitz, J. S. (2016). The effects of safety behaviors during exposure therapy for anxiety: Critical analysis from an inhibitory learning perspective. Clinical Psychology Review, 49, 115.Google Scholar
Blakey, S. M., Abramowitz, J. S., Buchholz, J. L., Jessup, S. C., Jacoby, R. J., Reuman, L., & Pentel, K. Z. (2019). A randomized controlled trial of the judicious use of safety behaviors during exposure therapy. Behaviour Research and Therapy, 112, 2835.Google Scholar
Boschen, M. J., Veale, D., Ellison, N., & Reddell, T. (2013). The emetophobia questionnaire (EmetQ-13): Psychometric validation of a measure of specific phobia of vomiting. Journal of Anxiety Disorders, 27(7), 670677.Google Scholar
Brown, T. A., & Barlow, D. H. (2014). Anxiety and related disorders interview schedule for DSM-5 (ADIS-5): Client interview schedule. Oxford University Press.Google Scholar
Butler, G. (1989). Phobic disorders. In Hawton, K., Salkovskis, P. M., Kirk, J., & Clark, D. M. (Eds.), Cognitive behaviour therapy for psychiatric problems: A practical guide (pp. 97128). Oxford University Press.Google Scholar
Cutshall, C., & Watson, D. (2004). The phobic stimuli response scales: A new self-report measure of fear. Behaviour Research and Therapy, 42, 11931201.Google Scholar
Davis, T. E. III, Ollendick, T. H., & Ost, L. G. (2012). Intensive one-session treatment of specific phobias. Springer-Verlag.CrossRefGoogle Scholar
First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2015). Structured clinical interview for DSM-5: Research version. American Psychiatric Publishing.Google Scholar
Freeman, D., Haselton, P., Freeman, J., et al. (2018). Automated psychological therapy using immersive virtual reality for treatment of fear of heights: A single-blind, parallel-group, randomised controlled trial. Lancet Psychiatry, 5(8), 625632.Google Scholar
Freud, S. (1909). Analysis of a phobia of a five-year old boy. In Case Histories, vol. 8 (pp. 169306). Pelican Library.Google Scholar
Helbig-Lang, S., & Petermann, F. (2010). Tolerate or eliminate? A systematic review on the effects of safety behavior across anxiety disorders. Clinical Psychology: Science and Practice, 17(3), 218233.Google Scholar
Hood, L., Fenwick, J., & Butt, J. (2010). A story of scrutiny and fear: Australian midwives' experiences of an external review of obstetric services, being involved with litigation and the impact on clinical practice. Midwifery, 26(3), 268285.Google Scholar
Lang, P. J. (1968). Fear reduction and fear behavior: Problems in treating a construct. In Shiler, J. M. (Ed.), Research in psychotherapy (Vol. 3) (pp. 90–102). American Psychological Association.Google Scholar
Marks, I. M. (1987). Fears, phobias and rituals. Oxford University Press.Google Scholar
Marks, I. M. (1997). Behaviour therapy for obsessive-compulsive disorder: a decade of progress. Canadian Journal of Psychiatry, 42(10), 10211027.Google Scholar
Marks, I. M., & Mathews, A. M. (1979). Brief standard self-rating for phobic patients. Behaviour Research and Therapy, 17, 263267.CrossRefGoogle ScholarPubMed
Muris, P., & Merckelbach, H. (1996). A comparison of two spider fear questionnaires. Journal of Behavior Therapy and Experimental Psychiatry, 27(3), 241244.CrossRefGoogle ScholarPubMed
Öst, L. G. (1989). One-session treatment for specific phobias. Behaviour Research and Therapy, 27(1), 17.CrossRefGoogle ScholarPubMed
Öst, L. G. (2007). The claustrophobia scale: A psychometric evaluation. Behaviour Research and Therapy, 45(5), 10531064.CrossRefGoogle Scholar
Öst, L. G., Salkovskis, P. M., & Hellstrom, K. (1991). One-session therapist-directed exposure vs self-exposure in the treatment of spider phobia. Behavior Therapy, 22(3), 407422.Google Scholar
Ost, L. G., & Sterner, U. (1987). Applied tension: A specific behavioural method for treatment of blood phobia. Behaviour Research and Therapy, 25, 2530.Google Scholar
Ovanessian, M. M., Fairbrother, N., Vorstenbosch, V., McCabe, R. E., Rowa, K., & Antony, M. M. (2019). Psychometric properties and clinical utility of the specific phobia questionnaire in an anxiety disorders sample. Journal of Psychopathology and Behavioral Assessment, 41, 3652.Google Scholar
Page, A. C., Bennett, K. S., Carter, O., Smith, J., & Woodmore, K. (1997). Assessing a structure of phobic symptoms elicited by blood and injections. Behaviour Research and Therapy, 35(5), 457464.Google Scholar
Rachman, S., Radomsky, A. S., & Shafran, R. (2008). Safety behaviour: A reconsideration. Behaviour Research and Therapy, 46(2), 163173.CrossRefGoogle ScholarPubMed
Radomsky, A. S., Rachman, S., Thordarson, D. S., McIsaac, H. K., & Teachman, B. A. (2001). The Claustrophobia Questionnaire. Journal of Anxiety Disorders, 15(4), 287297.Google Scholar
Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic: A cognitive account. Behavioural Psychotherapy, 19(1), 619.Google Scholar
Silverman, W. K., & Ollendick, T. H. (2005). Evidence-based assessment of anxiety and its disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34(3), 380411.CrossRefGoogle ScholarPubMed
Steinman, S., & Teachman, B. (2011). Cognitive processing and acrophobia: Validating the Heights Interpretation Questionnaire. Journal of Anxiety Disorders, 25, 896902.Google Scholar
Van Gerwen, L. J., Spinhoven, P., Van Dyck, R., & Diekstra, R. F. W. (1999). Construction and psychometric characteristics of two self-report questionnaires for the assessment of fear of flying. Psychological Assessment, 11(2), 146158.Google Scholar
Veale, D., Ellison, N., Boschen, M. J., Costa, A., Whelan, C., Muccio, F., et al. (2013). Development of an inventory to measure specific phobia of vomiting (emetophobia). Cognitive Therapy and Research, 37(3), 595604.Google Scholar
Vernon, L. L. (2007). Specific phobia. In Hersen, M. & Thomas, J. C. (Eds.), Handbook of clinical interviewing with adults. Sage Publications, 247270.Google Scholar
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, 10211037.Google Scholar
Wolpe, J. (1961). The systematic desensitization of neurosis. Journal of Nervous Mental Disorder, 132(March), 189203.Google Scholar
Wolpe, J., & Lang, P. J. (1964). A fear survey schedule for use in behaviour therapy. Behaviour Research and Therapy, 2, 2730.Google Scholar

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