Patients are at great risk for dropping out of treatment as this method repeatedly exposes the patient to the fear. Modeling—This method includes the clinician approaching the feared stimuli while the patient observes and tries to repeat the approach themselves.Exposures that are imaginal are less effective.Specifically for acrophobia, in-vivo exposure (exposure to real-world height-scenarios while maintaining anxiety at controlled levels) has been shown to significantly improve measures of anxiety in the short-term, but this effect decreased over a longer term. Likewise, virtual reality exposure was statistically significant in some measures of anxiety reduction, but not others. Pharmacotherapeutics
As of late 2020, there is limited evidence for the use of pharmacotherapy in the treatment of specific phobia. Pharmacological treatments are typically used in combination with behaviorally-focused psychotherapy, as introducing pharmacological interventions independently may result in relapsing of symptoms. Different treatments are better suited for certain types of specific phobia. For instance, beta blockers are useful in those with performance anxiety. The selective serotonin re-uptake inhibitors (SSRIs), paroxetine and escitalopram, have shown preliminary efficacy in small randomized controlled clinical trials. However, these trials were too small to show any definitive benefits of anxiolytic medication alone in treating phobia. Benzodiazepines are occasionally used for acute symptom relief, but have not been shown to be effective for long-term treatment. There are some findings suggesting that adjuvant use of the NMDA receptor partial agonist, d-cycloserine, with virtual reality exposure therapy may improve specific phobia symptoms more than virtual reality exposure therapy alone.
Natural environment type – Including fear of water (aquaphobia), heights (acrophobia), lightning and thunderstorms (astraphobia), or aging (gerascophobia). Situational type – Including the fear of small confined spaces (claustrophobia), or the dark (nyctophobia). Blood/injection/injury type – Including fear of medical procedures, including needles and injections (trypanophobia), fear of blood (hemophobia) and fear of getting injured (traumatophobia). Other – Situations which can lead to choking or vomiting, and childrens fears of loud sounds or costumed characters.Although the avoidance resulting from specific phobia is comparable to other anxiety disorders, differential diagnosis is done through examining underlying causes for the behavior. Agoraphobia is also considered distinct from specific phobia, along with substance use disorders, and avoidant personality disorder. The occurrence of panic attacks is not itself a symptom of specific phobias and falls under the criteria of panic disorder. Treatment
There are a variety of treatment options available for specific phobias, most of which focus on psychosocial interventions. Different psychological treatments have varying levels of effects depending on the specific phobia being addressed. Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy is a short term, skills-focused therapy that aims to help people diffuse unhelpful emotional responses by helping people consider them differently or change their behavior. CBT represents the gold standard and first line of therapy in specific phobias. CBT is effective in treating specific phobias primarily through exposure and cognitive strategies to overcome a persons anxiety. Computer-assisted treatment programs, self-help manuals, and delivery by a trained practitioner are all methods of accessing CBT.