Many people have phobias, irrational fear of animals, events, or actions, which cause significant damage to their normal functioning. Such activities as driving and flying and such animals as dogs and insects are among the most widespread phobias. In the United States, approximately 4.4 percent of the population has one or more phobias (Moldovan & David, 2014). This condition is highly treatable compared to other psychological diseases. Cognitive behavioral therapy (CBT) is one of the most relevant ways to assist people with a phobia, which is based on working with a patient’s anxiety response. This paper will target the recent academic literature to examine the role of behavioral treatment of phobias.
One of the key concepts of CBT is that the source of a patient’s problems most likely lies inside the person, not outside. The discomfort experienced because of a phobia is not delivered by situations yet by personal thoughts, assessments of conditions, and attitudes towards other people. A phobia is usually an unrealistic fear of someone or something that is characterized by anxiety, panic, and depression. As a rule, phobias are treatable with a high level of positive outcomes being achieved. In CBT, the patient researches his or her mindset along with the therapist (Triscari, Faraci, Catalisano, D’Angelo, & Urso, 2015). By asking various questions, often ridiculous or tricky, and suggesting conducting experiments, the therapist encourages the client to detect irrational logic and try to challenge it.
The review of the available literature shows that most often, CBT is used in combination with other non-pharmacological methods. In their study, Triscari et al. (2015) explored the integration of CBT with eye movement desensitization and reprocessing (EMDR), overall desensitization, and virtual reality (VR) exposure. Aerophobia was selected as the target phobia, and the efficacy of all the interventions was proved. In particular, the randomized controlled trial revealed that pre-and post-intervention demonstrated the reduction of the fear of flying. The participation of the tested patients in flights after the treatment as well as their self-reporting showed that their anxiety levels decreased. Within a one-year follow-up, the respondents also remained more positive to flights than before the application of CBT in the combination with other therapies.
Another way to address phobias is associated with virtual reality and CBT. This form of psychotherapy is based on technologically advanced applications the goal of which is to create an interactive environment and place a patient in it. Moldovan and David (2014) examined the impact of one session of CBT-VR on specific and social phobias. Based on examining 32 patients, they utilized such measurements as Flight Anxiety Modality Questionnaire (FAM), Self-Statements during Public Speaking Scale (SSPS), and other instruments. In the course of the intervention, the patients were taught to identify their irrational beliefs and replace them with logical thoughts. Together with the patients, the therapists constructed the hierarchy of phobias and built conversations that were specifically called to help to eliminate fears. As a result, it was established that the difference between the control and intervention groups did not achieve the expected significance level. Moldovan and David (2014) note that the small sample size and a variety of measurements may have limited the findings. Nevertheless, the study is representative of the fact that CBT-VR has the potential for changing irrational fears.
Not only adults but also children and adolescents may develop phobias, which makes it important to consider related articles as well. The peculiar feature of children’s phobias is that patients are afraid of the outcomes in real situations like inadequate behaviors in social situations. As a result, their relationships with peers can be challenged and determined the quality of behaviors in the future. According to Öst, Cederlund, and Reuterskiöld (2015), social phobia is the most critical in the identified group, and it may become chronic if untreated for a long period. The authors examined the impact of individual CBT and group exposure on 55 children aged between 8 and 14 years old (Öst et al., 2015). In addition, some children participated in the experiment together with their parents, who received education training on how to help their children to overcome their phobias. The data obtained demonstrated that there was no significant difference between those who participated alone and those whose parents were also involved. In fact, both groups succeeded in recovering or minimizing their unrealistic fears. These results show that CBT is effective for children regardless of the participation of their parents in the treatment process.
Even though the abovementioned studies were successful with regard to phobia treatment, it is essential to focus on some critical points. For example, Triscari et al. (2015) found that CBT with EMDR requires the professionalism of a therapist, who is expected to know and implement a set of theoretical orientations that vary depending on a certain patient and his or her phobia. In its turn, the use of VR along with CBT was recognized as an expensive therapy, which is consistent with another study results provided by Moldovan and David (2014). Therefore, further research should be initiated to improve the understanding of CBT and other behavioral techniques in addressing phobias.
To conclude, it is essential to emphasize that CBT is an effective means of treating various phobias in both children and adults. The contemporary studies show that CBT is often applied in combination with VR, EMDR, and other behavioral methods. However, if several techniques are applied to the same patient, it is important to assess each outcome and behavioral change and continue communication. To promote a greater understanding of the discussed topic, further research should focus on such aspects of behavioral treatment of phobias as costs, benefits, disadvantages, limitations, and opportunities regarding the integration with other techniques.
References
Moldovan, R., & David, D. (2014). One session treatment of cognitive and behavioral therapy and virtual reality for social and specific phobias. Preliminary results from a randomized clinical trial. Journal of Evidence-Based Psychotherapies, 14(1), 67–83.
Öst, L. G., Cederlund, R., & Reuterskiöld, L. (2015). Behavioral treatment of social phobia in youth: Does parent education training improve the outcome? Behaviour Research and Therapy, 67, 19–29.
Triscari, M. T., Faraci, P., Catalisano, D., D’Angelo, V., & Urso, V. (2015). Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: A randomized trial. Neuropsychiatric Disease and Treatment, 11, 2591–2598.