Psychological approaches in the treatment of specific phobias: A meta-analysis

Data from 33 randomized treatment studies were subjected to a meta-analysis to address questions surrounding the efficacy of psychological approaches in the treatment of specific phobia. As expected, exposure-based treatment produced large effects sizes relative to no treatment. They also outperformed placebo conditions and alternative active psychotherapeutic approaches. Treatments involving in vivo contact with the phobic target also outperformed alternative modes of exposure (e.g., imaginal exposure, virtual reality, etc.) at post-treatment but not at follow-up. Placebo treatments were significantly more effective than no treatment suggesting that specific phobia sufferers are moderately responsive to placebo interventions. Multi-session treatments marginally outperformed single-session treatments on domain-specific questionnaire measures of phobic dysfunction, and moderator analyses revealed that more sessions predicted more favorable outcomes. Contrary to expectation, effect sizes for the major comparisons of interest were not moderated by type of specific phobia. These findings provide the first quantitative summary evidence supporting the superiority of exposure-based treatments over alternative treatment approaches for those presenting with specific phobia. Recommendations for future research are also discussed

Virtual Reality as a Tool for Cognitive Behavioural Therapy: A Review.

This chapter describes the deployment of Virtual Reality (VR) for Cognitive Behavioral Therapy (CBT) to treat anxiety and other psychological disorders. Regarding anxiety, the most common technique is constituted of Exposure Therapy that, transposed to Virtual Reality, allows the patient to face a digital version of the feared object or situation, instead of a real or imaginal one. Virtual Reality Exposure Therapy (VRET) has proved effective in the treatment of anxiety disorders such as social phobia, Post-Traumatic Stress Disorder (PTSD), and panic disorder with agoraphobia and has shown an efficacy comparable to traditional in-vivo exposure with various specific phobias such as arachnophobia, acrophobia, and fear of flying. Thanks to its versatility, VR has also found an employment within the CBT framework with other psychological disorders, such as substance abuse, eating disorders, and in inducing non-pharmacological analgesia in patients undergoing painful medical procedures. Even when VR-based therapy does not lead to better results than traditional CBT in terms of efficacy, there are several reasons for preferring it over in-vivo exposure, including patient\u2019s comfort and safety, as well as the possibility to create complex or delicate scenarios (e.g. PTSD scenarios). In addition, VRET can be employed to facilitate the transition toward fearful objects in the real world in patients who would otherwise refuse to face real stimuli