Note: Here's my final research(ish) paper for this summer's Psychology course, for which I got an A (both in the course and on the paper). I call it a "research(ish)" paper because it's not a formal research paper. Rather, the prof just wanted us to pick one style of therapy, one mental health issue, and explain (using tons of resources) how we'd use that style of therapy to treat the mental health issue we chose.
Also, due to the craziness that was/is the Quarry fire, which, of course, had to happen during my finals week, I haven't really sat down to write anything else. So, that's why I put this (and my Sociology paper) up this week, instead of something that I actually enjoyed writing. Oh well... It is what it is.
Maya Nibbe
PSY2440101
Prof
7-23-2024
Using Cognitive Behavioral Therapy to Treat One’s Phobias
There are many different approaches to therapy that have been developed over the years, many of which are still used today to successfully diagnose and treat a myriad of mental health issues. One very common form of therapy is known as Cognitive Behavioral Therapy, or CBT, which was created by psychologist Albert Ellis, who originally called CBT Rational Emotive Therapy in the 1960s (Bael, 2023). Ellis believed that people were unhappy due to their irrational beliefs, which negatively tainted their view of events that happened to them (Bael, 2023). Therefore if people wanted to become happier and healthier, they had to change their irrational beliefs to be more rational (Bael, 2023).
Later on, psychologist Aaron T. Beck renamed Rational Emotive Therapy to Cognitive Therapy, which utilized many of Ellis’ techniques but added on the idea that emotions caused stress, therefore, to reduce stress one must change their emotions by thinking happier, more rational thoughts (Bael, 2023). Finally, a psychiatrist who was heavily influenced by Ellis called Maxie Maultsby came up with Rational Behavior Therapy, which combined a handful of different therapies and techniques together, such as operant conditioning and Rational Emotive Therapy, to help patients overcome their fears (Bael, 2023).
Since then, Cognitive Behavioral Therapy has branched out into many different forms, all of which have their roots in the idea that thinking affects behavior, so in order to change one’s behavior, one must change their thinking (Bael, 2023). One such form of CBT is known as Exposure Therapy, which has been successfully used to help people combat many of their specific phobias by helping a person face their fears gradually and rationally (Kaczkurkin & Foa, 2022).
Specific phobias, as the name suggests, are specific irrational fears unique to each individual person, and it’s estimated that about 14% of the global adult population has at least one phobia (Zsido et al., 2023). In fact, specific phobia disorders are the most common type of anxiety disorders among adults, and about 27% of the world’s population will develop at least one phobia within their lifetimes (Zsido et al., 2023). About 1 in 500 people worldwide suffer from a phobia so severe that they spend their whole lives actively avoiding that phobia, to the point that they can’t lead normal, healthy lives (McDougal, 2023). For these people, their reaction to their fear is so extreme that they’ll often suffer from a full-fledged panic attack when confronted with their fear, and do everything in their power to get away from it (McDougal, 2023). Phobias tend to persist and even get worse as time goes on, and sometimes a phobia that was once successfully dealt with will return in response to something else that causes one to be afraid (McDougal, 2023).
Luckily for psychologists, phobias are relatively easy to diagnose. The Diagnostic and Statistical Manual 5th Edition, which is what psychologists currently use to help them diagnose various mental disorders, lists Specific Phobias as anxiety disorders, and has a chart of symptoms a patient must meet to be officially diagnosed with a Specific Phobia (American Psychiatric Association, 2013). In order to be officially diagnosed with a Specific Phobia, one must be consistently afraid of something for at least six months, do everything in their power to avoid that which they fear, and immediately panic when confronted with their fear no matter what, among other symptoms (American Psychiatric Association, 2013).
For instance, in one case study, a psychotherapist named Katie Elmhurst suffered from a severe phobia of balloons for her whole life, to the point that she avoided every occasion where there would likely be balloons (Elmhurst & Thyer, 2023). One day, Elmhurst asked one of her professors, Dr. Bruce Thyer, to help her overcome her fear (Elmhurst & Thyer, 2023). According to Dr. Thyer, Elmhurst met the DSM-V criteria for having a severe phobia of balloons, and agreed to both treat her phobia and use it as a case study for Exposure Therapy (Elmhurst & Thyer, 2023).
To treat Elmhurst’s crippling fear of balloons, Dr. Thyer started by having Elmhurst wear a heartrate monitor on her finger while he introduced her to a room with a balloon in it (Elmhurst & Thyer, 2023). After bringing Elmhurst as close to the ballon as she could tolerate, while recording her feelings and heartrate as she got closer to it, Dr. Thyer asked Elmhurst to go home and watch YouTube videos of balloons to continue Exposure Therapy on her own before going to another in-person session of Exposure Therapy (Elmhurst & Thyer, 2023). Over time, Elmhurst’s anxiety surrounding balloons diminished the more she was exposed to balloons, both online and in real life, to the point that she no longer met the DSM-V criteria for having a specific phobia of balloons by the end of that year (Elmhurst & Thyer, 2023). In fact, Elmhurst was able to spend that December hosting and attending parties where she was surrounded by balloons, and not once did she feel afraid (Elmhurst & Thyer, 2023). Evidently, her fear of balloons had been completely conquered thanks to Exposure Therapy.
However, Katie Elmhurst is far from the only person whose phobia has been successfully treated using Exposure Therapy. In a different study, Russian researchers wanted to test the effectiveness of Virtual Reality Exposure Therapy against traditional Exposure Therapy, knowing that traditional Exposure Therapy was already proven to be highly effective when helping people overcome their irrational fears (Jurick et al., 2024).
In this study, 55 participants who were terrified of spiders managed to get through the entire study, wherein they were either made to do Virtual Reality Exposure Therapy or traditional Exposure Therapy (Jurick et al., 2024). When doing traditional Exposure Therapy, participants were encouraged to look at a tarantula in a glass container in-person and rate their fear on a scale of 0-10 (Jurick et al., 2024). Participants in the Virtual Reality Exposure Therapy group were asked to wear a VR headset and interact with a digital Wasp spider, which is a spider found all throughout Russia (Jurick et al., 2024). By the end of the study, which included a checkup one month after the participants went through both forms of Exposure Therapy, 54 out of the 55 participants lost their fear of spiders, showing yet again that both traditional Exposure Therapy and Virtual Reality Exposure Therapy are highly effective when used to help people overcome their phobias (Jurick et al., 2024).
Last but not least, a group of researchers out of India recently reviewed dozens of independent studies on Exposure Therapy and Virtual Reality Exposure Therapy, wherein they concluded that both forms of Exposure Therapy were extremely effective when treating phobias (Vrushali & Dimple, 2024). All 44 studies the researchers reviewed showed significant improvements among participants with severe phobias who underwent Exposure Therapy, compared to those who were kept in control groups, and/or went through different types of therapy to help them overcome their fears (Vrushali & Dimple, 2024).
Whether it’s traditional Exposure Therapy or Virtual Reality Exposure Therapy, people who undergo either form of Exposure Therapy are very likely to get over their phobias. As Dr. Kaczkurkin and Dr. Foa write, “Meta-analytical studies have shown that in vivo exposure therapy is highly effective for specific phobias compared with no treatment, placebo treatment, and non-exposure-based active therapy con-ditions.” (Kaczkurkin & Foa, 2022, p. 340). Evidently, Exposure Therapy remains the best form of therapy when it comes to successfully treating people with severe, specific phobias. And when psychologists encounter patients with specific phobias, Exposure Therapy should be the very first thing they try to help their patients overcome their phobias.
Reference Page
Beal, D. (2023). Cognitive behavior therapy (CBT). Salem Press Encyclopedia of Health. https://research-ebsco-com.ccco.idm.oclc.org/c/vijme7/viewer/html/bre7ejlhgn.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. (5th ed.). American Psychiatric Publishing. https://repository.poltekkes-kaltim.ac.id/657/1/Diagnostic%20and%20statistical%20manual%20of%20mental%20disorders%20_%20DSM-5%20(%20PDFDrive.com%20).pdf.
Kaczkurkin, A., & Foa, E. (2022, Apr. 01). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in Clinical Neuroscience. 17(3), 337-346. https://www.tandfonline.com/doi/epdf/10.31887/DCNS.2015.17.3/akaczkurkin?needAccess=true.
Zsido, A., & Kiss, B., & Basler, J., & Birkas, B., & Coelho, C. (2023). Key factors behind various specific phobia subtypes. Nature. 13(1), 22281. https://doi-org.ccco.idm.oclc.org/10.1038/s41598-023-49691-0.
McDougal, D. (2023). Phobias. Salem Press Encyclopedia of Health. https://research-ebsco-com.ccco.idm.oclc.org/c/vijme7/viewer/html/wsx6mfa6bf.
Elmhurst, K., & Thyer, B. (2023). Self-Conducted and Skype-Mediated Exposure Therapy for a Severe Balloon Phobia: A Single-Case Design. Best Practice in Mental Health. 19(1), 65-76. https://research-ebsco-com.ccco.idm.oclc.org/c/vijme7/viewer/pdf/3cgvxd6oyz.
Jurick, T., & Zaremba-Pike, S., & Kosonogov, V., & Mohammed, A., & Krasavtseva, Y., & Sawada, T., & Samarina, I., & Buranova, N., & Adu, P., & Sergeev, N., & Skuratov, A., & Demchenko, A., & Kochetkov, Y. (2024, Feb. 19). The efficacy of augmented reality exposure therapy in the treatment of spider phobia—a randomized controlled trial. Frontiers in Psychology. 15. https://doi.org/10.3389/fpsyg.2024.1214125.
Vrushali, V., & Dimple, P. (2024). Virtual Reality Exposure Therapy for Patients with Phobic Disorder: A Systematic Review. Indian Association of Health, Research and Welfare. 15(1), 69-77. https://research-ebsco-com.ccco.idm.oclc.org/c/vijme7/viewer/pdf/l7m5blb4wr.