Specific Phobia Treatment

Help for Fears and Phobias

Here at the CTSA we are committed to providing empirically-supported treatments. In other words, the treatments that we use have been shown, through careful research, to work for many, if not most, people.

We have found that while avoidance of what provokes our anxiety may make us feel better right now, over time it allows these situations, thoughts, and emotions to stay "scary" and therefore for anxiety about them to keep coming back. In therapy for specific phobias we aim to combat this avoidance in a few different ways.

1. The most commonly used and effective technique for combating specific phobias is called "in vivo exposure" or "in-real-life exposure." In vivo exposure is the confrontation of feared things, places, or situations that have previously been avoided. In therapy, the client and therapist create a "hierarchy" or a list of feared situations related to the phobia that ranges from slightly anxiety-provoking to very anxiety-provoking. The therapist helps the client confront these situations one by one and stay in them until the client's anxiety naturally decreases. Slowly, the client works up the hierarchy and is able to confront scarier and scarier situations both with the therapist, and without, until their anxiety is sufficiently reduced.


2. Occasionally another type of exposure, called "imaginal exposure" is used to combat a specific phobia. Imaginal exposure is the confrontation of a feared situation or possible turn of events by describing this situation in detail in the therapy session. The therapist helps the client create a story, or a "script" of a feared situation involving the phobia, often a worst case scenario of what might happen if the phobic object or situation is confronted. The therapist helps the client recount this script, in detail, in the therapy session until the anxiety surrounding the feared situation is naturally reduced. This can be used for all types of phobias, but can be particularly helpful when the phobia is surrounding something that is not easily confronted or reproduced "in real life" — for instance for phobias of thunderstorms, or of airplanes, if air travel is not easily accessible.

Resources for Patients

An example of brief behavioral treatment for snake phobia at Boston University's Center for Anxiety and Related Disorder's (CARD): Part 1 | Part 2 | Part 3 .