Traditional systematic desensitization involves a person being exposed to the object they are afraid of over time so that the fear and discomfort do not become overwhelming. This controlled exposure to the anxiety-provoking stimulus is key to the effectiveness of exposure therapy in the treatment of specific phobias. It has been shown that humor is an excellent alternative when traditional systematic desensitization is ineffective. Humor systematic desensitization involves a series of treatment activities that elicit humor with the feared object. Previously learned progressive muscle relaxation procedures can be used as the activities become more difficult. Progressive muscle relaxation helps people relax before and during exposure to the feared stimulus. Virtual reality therapy is another technique that helps phobic people confront a feared object. It uses virtual reality to generate scenes that may not have been possible or ethical in the physical world. It is equally as effective as traditional exposure therapy and offers additional advantages. These include controlling the scenes and having the phobic person endure more exposure than they might handle in reality. Medications
Medications are a treatment option often utilized in combination with CBT or if CBT was not tolerated or effective. Medications can help regulate apprehension and fear of a particular fearful object or situation. There are various medication options available for both social anxiety disorder and agoraphobia. The use of medications for specific phobias, besides the limited role of benzodiazepines, do not currently have established guidelines due to minimal supporting evidence.
Hypnotherapy
Hypnotherapy can be used alone and in conjunction with systematic desensitization to treat phobias. Through hypnotherapy, the underlying cause of the phobia may be uncovered. The phobia may be caused by a past event that the person does not remember, a phenomenon known as repression. The mind represses traumatic memories from the conscious mind until the person is ready to deal with them. Hypnotherapy may also eliminate the conditioned responses that occur during different situations. People are first placed into a hypnotic trance, an extremely relaxed state in which the unconscious can be retrieved. This state makes people more open to suggestion, which helps bring about desired change. Consciously addressing old memories helps individuals understand the event and see it less threateningly. Prognosis
Outcomes vary widely among the phobic anxiety disorders. There is a possibility that remission occurs without intervention but relapses are common. Response to treatment as well as remission and relapse rates are impacted by the severity of an individuals disorder as well as how long they have been experiencing symptoms. For example, in social anxiety disorder (social phobia) a majority of individuals will experience remission within the first couple of years of symptom onset without specific treatment. On the other hand, in Agoraphobia as few as 10% of individuals are seen to reach complete remission without treatment. A study looking at the 2 year remission rates for anxiety disorders found that those with multiple anxieties were less likely to experience remission.