Abstract
Specific phobia is one of the most common and easily treated mental disorders. In this review, empirically supported assessment and treatment procedures for specific phobia are discussed. Exposure-based treatments in particular are highlighted given their demonstrated effectiveness for this condition. The format and characteristics of exposure-based treatment and predictors of treatment response are outlined to provide recommendations for maximizing outcome. In addition, several other treatments for specific phobia are reviewed and critiqued, including cognitive therapy, virtual reality, eye movement desensitization and reprocessing, applied tension, and pharmacologic treatments. The review concludes with a discussion of future directions for research.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References and Recommended Reading
Eaton WW, Dryman A, Weissman MM: Panic and phobia. In Psychiatric Disorders in America: The Epidemiological Catchment Area Study. Edited by Robins LN, Regier DA. New York: Free Press; 1991:155–179.
Kessler RC, Chiu WT, Demler O, et al.: Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005, 62:617–627.
Curtis GC, Magee WJ, Eaton WW, et al.: Specific fears and phobias: epidemiology and classification. Br J Psychiatry 1998, 173:212–217.
Antony MM, Barlow DH: Specific phobias. In Anxiety and its Disorders: The Nature and Treatment of Anxiety and Panic, edn 2. Edited by Barlow DH. New York: Guilford Publications; 2001:380–417.
Brown TA, Campbell LA, Lehman CL, et al.: Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. J Abnorm Psychol 2001, 110:585–599.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, edn 4. Washington, DC: American Psychiatric Association; 2000.
Antony MM: Measures for specific phobia. In Practitioner’s Guide to Empirically-Based Measures of Anxiety. Edited by Antony MM, Orsillo SM, Roemer L. New York: Kluwer Academic/Plenum; 2001:133–158.
McCabe RE, Antony MM: Specific and social phobia. In Handbook of Assessment and Treatment Planning for Psychological Disorders. Edited by Antony MM, Barlow DH: New York: Guilford Publications; 2000:113–146.
Brown TA, Di Nardo P, Barlow DH: Anxiety Disorders Interview Schedule for DSM-IV (Lifetime Version). New York: Oxford University Press; 1994.
First MB, Spitzer RL, Gibbon M, et al.: Structured Clinical Interview for DSM-IV Axis I Disorders—Patient Edition (SCID-I/P, Version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute; 1996.
Klieger DM: The Snake Anxiety Questionnaire as a measure of ophidophobia. Educ Psychol Meas 1987, 47:449–459.
Antony MM, Swinson RP: Phobic Disorders and Panic in Adults: A Guide to Assessment and Treatment. Washington, DC: American Psychological Association; 2000.
Geer JH: The development of a scale to measure fear. Behav Res Ther 1965, 3:45–53.
Klieger DM, Franklin ME: Validity of the Fear Survey Schedule in phobia research: a laboratory test. J Psychopathol Behav Assess 1993, 15:207–217.
Antony MM, McCabe RE, Leeuw I, et al.: Effect of exposure and coping style on in vivo exposure for specific phobia of spiders. Behav Res Ther 2001, 39:1137–1150.
Öst LG, Ferebee I, Furmark T: One-session group therapy of spider phobia: direct versus indirect treatments. Behav Res Ther 1997, 35:721–732.
Öst LG, Salkovskis PM, Hellström K: One-session therapist-directed exposure vs. self-exposure in the treatment of spider phobia. Behav Ther 1991, 22:407–422.
Gauthier J, Marshall WL: The determination of optimal exposure to phobic stimuli in flooding therapy. Behav Res Ther 1977, 15:403–410.
Öst LG: Behavioral treatments of thunder and lightning phobias. Behav Res Ther 1978, 16:197–207.
Menzies RG, Clarke JC: A comparison of in vivo and vicarious exposure in the treatment of childhood water phobia. Behav Res Ther 1993, 31:9–15.
Bourque P, Ladouceur R: An investigation of various performance-based treatments with acrophobics. Behav Res Ther 1980, 18:161–170.
Beckman JC, Vrana SR, May JG, et al.: Emotional processing and fear measurement synchrony as indicators of treatment outcome in fear of flying. J Behav Ther Exp Psychiatry 1990, 21:153–162.
Öst LG, Brandberg M, Alm T: One versus five sessions of exposure in the treatment of flying phobia. Behav Res Ther 1997, 35:987–996.
Craske MG, Mohlman J, Yi J, et al.: Treatment of claustrophobia and snake/spider phobias: fear of arousal and fear of context. Behav Res Ther 1995, 33:197–203.
Greenberg DB, Stern TA, Weilburg JB: The fear of choking: three successfully treated cases. Psychosomatics 1988, 29:126–129.
Moore R, Brodsgaard I: Group therapy compared with individual desensitization for dental anxiety. Community Dent Oral Epidemiol 1994, 22:258–262.
Öst LG, Fellenius J, Sterner U: Applied tension, exposure in vivo, and tension-only in treatment of blood phobia. Behav Res Ther 1991, 29:561–574.
Horowitz JD, Wolitzky KB, Powers M, et al.: Psychosocial treatments for specific phobias: a meta-analysis. Poster presented at the 39th Annual Convention of the Association for Behavioral and Cognitive Therapies. Washington, DC; November 17–20, 2005.
Stern R, Marks I: Brief and prolonged flooding: a comparison in agoraphobic patients. Arch Gen Psychiatry 1973, 28:270–276.
Foa EB, Jameson JS, Turner RM, et al.: Massed versus spaced exposure sessions in the treatment of agoraphobia. Behav Res Ther 1980, 18:333–338.
Rowe MK, Craske MG: Effects of an expanding-spaced vs. massed exposure schedule on fear reduction and return of fear. Behav Res Ther 1998, 36:701–717.
Lang AJ, Craske MG: Manipulations of exposure-based therapy to reduce return of fear: a replication. Behav Res Ther 2000, 38:1–12.
Bouton ME, Mineka S, Barlow DH: A modern learning theory perspective on the etiology of panic disorder. Psychol Rev 2001, 108:4–32.
Rowe MK, Craske MG: Effects of varied-stimulus exposure training on fear reduction and return of fear. Behav Res Ther 1998, 36:719–734.
Öst LG: One-session group treatment for spider phobia. Behav Res Ther 1996, 34:707–715.
Hellström K, Öst LG: One-session therapist directed exposure vs. two forms of manual directed self-exposure in the treatment of spider phobia. Behav Res Ther 1995, 33:959–965.
Marks IM, Kenwright M, McDonough M, et al.: Saving clinicians’ time by delegating routine aspects of therapy to a computer: a randomized controlled trial in phobia/panic disorder. Psychol Med 2004, 34:9–17. This article compares computer-guided self-exposures with clinician-guided exposures in patients with phobia or panic disorder. Results indicated that both treatments demonstrated comparable outcomes at post-treatment and 1-month follow-up.
Foa EB, Kozak MJ: Emotional processing of fear: exposure to corrective information. Psychol Bull 1986, 99:20–35.
Haw J, Dickerson M: The effects of distraction on desensitization and reprocessing. Behav Res Ther 1998, 36:765–769.
Craske MG, Rowe MK: A comparison of behavioral and cognitive treatments for phobias. In Phobias: A Handbook of Theory, Research, and Treatment. Edited by Davey GCL Chichester, England: John Wiley & Sons; 1997:247–280.
Emmelkamp PM, Krijn M, Hulsbosch AM, et al.: Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia. Behav Res Ther 2002, 40:509–516.
Rothbaum BO, Hodges LF, Smith S, et al.: A controlled study of virtual reality exposure therapy for fear of flying. J Consult Clin Psychol 2000, 68:1020–1026.
Rothbaum BO, Hodges L, Anderson PL, et al.: Twelvemonth follow-up of virtual reality and standard exposure therapies for the fear of flying. J Consult Clin Psychol 2002, 70:428–432. This article investigates the long-term effectiveness of VR treatments compared with standard exposure therapy and a wait-list control condition for fear of flying. Results indicated that both active treatments were equally superior to the control condition at post-treatment and 12-month follow-up.
Muris P, Merckelbach H, Holdrinet I, et al.: Treating phobic children: effects of EMDR versus exposure. J Consult Clin Psychol 1998, 66:193–198.
Muris P, Merckelbach H, van Haaften H, et al.: Eye movement desensitization and reprocessing versus exposure in vivo: a single-session crossover study of spider-phobic children. Br J Psychiatry 1997, 171:82–86.
Sanderson A, Carpenter R: Eye movement desensitization versus image confrontation: a single-session crossover study of 58 phobic subjects. J Behav Ther Exp Psychiatry 1992, 23:269–275.
Öst LG, Fellenius J, Sterner U: Applied tension, exposure in vivo, and tension-only in the treatment of blood phobia. Behav Res Ther 1991, 29:561–574.
Whitehead WE, Robinson A, Blackwell B, et al.: Flooding treatment of phobias: Does chronic diazepam increase effectiveness? J Behav Ther Exp Psychiatry 1978, 9:219–225.
Zoellner LA, Craske MG, Hussain A, et al.: Contextual effects of alprazolam during exposure therapy. Paper presented at the 30th Annual Convention of the Association for Advancement of Behavior Therapy. New York; November 21–24, 1996.
Thom A, Sartory G, Jöhren P: Comparison between one-session psychological treatment and benzodiazepine in dental phobia. J Consult Clin Psychol 2000, 68:378–387.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Grös, D.F., Antony, M.M. The assessment and treatment of specific phobias: A review. Curr Psychiatry Rep 8, 298–303 (2006). https://doi.org/10.1007/s11920-006-0066-3
Issue Date:
DOI: https://doi.org/10.1007/s11920-006-0066-3