Phobias relate to an irrational and persistent fear concerning specific objects, such as spiders and snakes, or situations having to do, for example, with heights or crowds. There are various treatments said to address such fears of which exposure therapy is one (Hirai, Vernon & Cochran, 2007). As the name implies, exposure therapy involves exposing individuals to the thing or situation they experience an irrational fear of. This can be accomplished in a number of ways: in vivo refers to direct exposure or confrontation; imaginal therapy asks individuals to visualize exposure to the object or situation most feared; and virtual reality therapy is computer-assisted treatment that immerses individuals and thereby facing their fears in a very controlled and artificial manner (Hirai, et al., 2007). Two different approaches can be utilized within the chosen therapeutic approach. First, treatment can be gradual whereby the individual in introduced to the object or situation incrementally. In such cases gradual treatment is augmented with cognitive behavioral (CB) techniques that assist with identifying automatic thoughts that are negative and reinforce fear, and relaxation techniques may be used to relieve tension. The other approach is brief, and exposes individuals to the object or situation very quickly; and while the brief approach, also referred as flooding, can also be augmented with CB and relaxation techniques, it most often is followed by a few other sessions that involve self-reports and assessments concerning progress (Hirai, et al., 2007).
Arachnophobia is the term used to describe an irrational fear of spiders and is reported to be the most prevalent of all specific phobias. As has been explained earlier in this paper, there are various ways that arachnophobia may be treated using exposure therapy. Hirai, et al., (2007) report that some successes have been reported using imaginal flooding and systematic desensitizing, but there is a limited amount of literature indication exactly how effective these treatments actually are. But, there does appear to be quite a bit of research that has been reported concerning single-session and group treatments which are explored below.
Single-session exposure therapy for spider phobia is relatively simplistic. Those who receive this type of therapy are exposed to actual living spiders over the course of 2-to-3 hours. During this session a therapist will expose individuals to a spider by introducing it slowly until the individual handles it. Approximately 80 percent of participants in research using a single-session technique reported significant improvements (Hirai, et al., 2007). The therapeutic process is similar when applied in group situations, except the therapist “treats” one group member by exposure to the spider and then this individual will model the treatment with others within the group. In this example, the duration of group sessions are the same as those for those attending individual treatment, and this approach appears to be as effective for small or large groups (Hirai, et al., 2007).
Researchers have also looked at what is potentially the most effective of group treatments, meaning they compared single-session in vivo exposure to that of gradual in vivo desensitization, as well as with video observation (where groups are exposed to spiders while watching films). While each approach was effective it was single-session in vivo exposure that was the most efficacious. Hirai, et al., (2007) also reported that the same was found when duplicating the tests. However, the effectiveness of single-session in vivo exposure therapy over that of other treatments was recorded through post-treatment interviews as well as through assessments conducted one year later. These findings are prefaced by two inherent problems reported by researchers. First, reactions by group members may actually illicit strong responses by others and thwart any positive gains. Secondly, therapists cannot focus on all members at the same time making it impossible to spot adverse reactions as they occur (Hirai, et al., 2007).
- Hirai, M., Vernon, L. L., & Cochran, H. (2007). Exposure therapy for phobias. In D. C. Richard & D. Lauterbach (Eds.), Handbook of exposure therapies (pp. 247-270). Burlington, MA: Elsevier/AP.