CBT Specific Phobia

CBT has been studied as a treatment for specific phobia (Craske & Rowe, 1997) either alone (Booth & Rachman, 1992; de Jongh et al., 1995; O'Donahue & Szymanski, 1993) or in combination with exposure-based treatments (Kamphuis &Telch, 2000; Koch, Spates,& Himle, 2004). In CBT, patients are taught to identify and alter their fears that maintain the phobic reaction, and the CBT techniques used to accomplish this include cognitive restructuring (de Jongh et al., 1995) and guided threat reappraisal (Kamphuis & Telch, 2000; Sloan & Telch, 2002). The addition of cognitive strategies enhances some treatment outcomes, but the results tend to be mixed, with some favoring exposure with a cognitive augmentation strategy (e.g., Kamphuis & Telch, 2000; Sloan & Telch, 2002) and others favoring other approaches (e.g., Szymanski & O'Donahue, 1995). On the other hand, Paquette et al. (2003) found that CBT is an effective psychotherapeutic approach for reducing the
Exposure may be conducted either in vivo (ie, direct confrontation to actual phobic stimuli/situations) or imaginal (ie, imagery-based representations) (Olatunji et al., 2010). However, technologic advances now allow for the use of virtual reality exposures to phobic stimuli that may be otherwise difficult to create in the standard treatment setting (e.g., flight phobia ). Also, in CBT treatment of phobias some approaches incorporate cognitive restructuring to address beliefs and expectancies that may contribute to the phobic anxiety. In conclusion, it should be pointed out that only one meta-analysis of specific phobia treatment outcome exists, and while CBT remains a potential for treating specific phobias, treatment outcomes are not yet convincing that CBT is the superior approach (Olatunji, et al., 2010). However, the effectiveness of CBT can be enhanced with the inclusion of in vivo exposure along with other cognitive