the efficacy of exposure therapy, in combination with other cognitive-behavioral therapy (cbt) components, in the treatment of specific phobia with a middle and older aged sample was examined. the current study aims to extent existing treatment protocols, including exposure therapy components, for specific phobias to a sample of older adults in order to assess the efficacy of such techniques among this population. within the mail-out sample (n = 159), a question had been asked of participants as to whether they whether they had a phobia and if they were interested in treatment. this measure has also been used in a number of studies with older adults, and has been found to be sensitive to post-treatment improvements in general functioning among older people (scogin et al 1992). participants in the treatment group were administered questionnaires at the conclusion of the initial group session (session one) and following the final individual exposure session (session ten).
in terms of treatment components, it was determined that session content should incorporate both in-vivo exposure techniques, which have consistently been found to be the cornerstone of phobia treatment, and other treatment components, such as psychoeducation, anxiety management and cognitive and relaxation procedures. this suggests that the impact of time on outcome variables differed between treatment groups. although past research has supported the extension of established treatment protocols for other anxiety symptoms and disorders to older people, none have examined the treatment of specific phobias among older populations. significant mid- and post-treatment reductions in depression are also in line with past research investigating the treatment of anxiety among older people, with many studies finding significant improvements in depression following anxiety treatment programs. although the recruitment difficulties that plague research attempts with older populations significantly impacted on both the strength and breadth of conclusions in the current instance, if current findings are extended by further research they have the potential to significantly impact on the treatment approach for older phobics.
challenges remain with the inherent heterogeneity of specific phobia as a disorder and the accompanying variability in outcome measures and intervention approaches to warrant a clear conclusion on efficacy. in particular, in vivo exposure appeared to be the most efficacious intervention for a wide variety of phobias, and a few studies obtained a response rate of 80 to 90%, based on a review by choy et al. these fears tend to be more pervasive in females than males 19. three studies that examined the fear of childbirth naturally restricted the samples to female participants. the authors found that although vret significantly reduced behavioural avoidance ( d = 1.49) to a large effect size, it was not more effective than in vivo exposure in the treatment of spider phobia measured at the end of treatment. vret was superior to pmr and psychoeducation in terms of the subjective units of distress experienced by the participants (measured after treatment). the effect of post-exposure cortisol administration was investigated in a double-blind placebo-controlled trial involving 43 subjects with spider phobia 36. cortisol did not add further benefit to exposure therapy and was found to have an adverse effect on fear renewal on the basis of behavioural approach tests at the 7-month follow-up.
a single session of itbs administered prior to immersion in a vr spider scene showed no effect on the subjective reactions provoked by vr. 47 studied the effect of giving a reactivation cue 30 minutes prior to in vivo exposure therapy for spider or snake phobia. the review also yielded a study that investigated relaxation in the treatment of blood-injection-injury phobias. a number of alternative and novel treatment options that sought to modify the cognitive pathway of activated fear responses and memories have gained empirical attention in the last five years. a number of the studies did not have sufficient sample sizes and therefore were not powered to adequately conclude whether the improvements were directly associated with the intervention or due to chance or extraneous factors not measured in the studies. challenges associated with the inherent heterogeneity of specific phobias need to be overcome in order for a more focused conclusion on treatment and its efficacy.
the best treatment for specific phobias is a form of psychotherapy called exposure therapy. sometimes your doctor may also recommend other talking treatments, such as counselling, are often very effective at treating phobias. in particular, cognitive behavioural therapy (cbt) and mindfulness have advances in therapies for specific phobias are promising, including the use of computer-assisted therapy, and the use of interoceptive exposure therapy (, .
an individual with a recent diagnosis of specific phobia is often very motivated to seek treatment once they learn that effective treatments are first-line treatment for specific phobia is cognitive-behavioral therapy (cbt) that includes exposure treatment . pharmacotherapy, phobias are common in later life, yet treatment research in this population remains scant. the efficacy of exposure therapy, in combination with other, .
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