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OF mental health care and mentally ill

Treatment efficacy: phobias

Roth and Fonagy  in their comprehensive review of anxiety disorders and ‘what works for whom?’ concluded: ‘There is little justification for using anything other than exposure treatments for specific phobias’. Undoubtedly, the most efficacy as demonstrated through randomized controlled treatment trials come from behaviour therapy using exposure and cognitive techniques. Such treatments can vary in length, with on average 8–12 sessions (including assessment) required for agoraphobia and social phobia, and up to 6 sessions for specific phobias. Interestingly, some specific phobias can be successfully treated with only 2 to 4 sessions.

It is important to note that there is no justification for the use of dynamic or humanistic therapies in the treatment of phobias. The NHS Centre for Reviews and Dissemination published a critical assessment of treatments for social phobia which found that exposure and cognitive behavioural treatments resulted in ‘significant and meaningful reductions in anxiety’. Furthermore, the review noted that the ‘combination of psychological and pharmacological treatments was disappointing and did not exceed the effects of psychological treatments alone’.

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