Phobia Treatment: Cognitive Behavioral Therapy

A phobia is an unrealistic fear of something, whether it be an object, such as an animal, or a situation, such as driving. Phobias are diagnosed when anxiety in response to the feared stimulus becomes so intense that it causes significant distress or impairs normal functioning. Phobias are highly treatable, and have the highest likelihood of positive outcomes as compared to all other psychological problems.

There is no question that the treatment of choice for phobias is a treatment called cognitive behavioral therapy (CBT). Numerous studies have shown that people who undergo a short course of CBT have a very high likelihood of significant improvement, with about 80-90% of people showing complete remission by the tenth session. Compare this with traditional talk therapy, in which only 60% of patients improve, and only after undergoing many more sessions. There is no question that CBT is the most effective treatment for phobias, and every other anxiety disorder for that matter.

Cognitive behavioral treatment for phobias involves un-pairing the anxiety response from the feared situation. CBT is able to do this partly by identifying problematic or irrational thinking patterns, and helping people take on new, more adaptive ways of thinking about challenging situations. Once these thought patterns are more helpful and realistic, CBT helps people extinguish the anxiety response by providing behavioral methods to help them face their fear without anxiety. Through this highly-targeted process of changing thoughts and behaviors, most people show significant improvement by their fifth session.

CBT varies from person to person, and is tailored to each person’s unique needs. However, CBT for phobias typically involves some combination of the following components:

Cognitive Restructuring: People with phobias often have catastrophic thoughts in relation to their phobia. Furthermore, most people with phobias underestimate their ability to cope with fear in difficult situations. Cognitive restructuring teaches people to identify these sorts of counterproductive thought patterns, and replace them with more realistic thoughts, that result in decreased anxiety and avoidance.

Systematic Exposure: Exposure works by helping people plan regular contact with what they fear, and repeatedly exposing themselves to the feared stimulus until it evokes little or no anxiety. This works by using a graded approach, in which the least anxiety-provoking stimulus is the starting point. Once the first stimulus is mastered, the person exposes herself to a stimulus that is slightly more triggering. For example, with spider phobia, the starting point may be talking about spiders, and the next step may be looking at pictures of spiders. Exposure usually works best when preceded by cognitive restructuring, as people’s anxiety often decreases significantly and feel more prepared to face their fears once they have changed their thinking.

Mindfulness Training: Mindfulness is a way of bringing one’s attention to the present. This is helpful in phobia treatment, because people are often so caught up by their thoughts about what they fear, that they have difficulty recognizing that when the feared object s present, it actually presents no threat. In other words, people can get so distracted by their thinking, that it becomes easy to tune out the environment.

At cognitive behavioral therapy Los Angeles, we specialize in CBT for anxiety disorders, such as phobias. Call or email today for an appointment.