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Types of Exposure Therapy Compared, Focus on Fearful Object Recommended
> 1/10/2008 2:35:44 PM

If you fear the right things at the right times, you will be safer. However, the fear response is easily mis-triggered, leading to phobias that can greatly impair quality of life. When phobias are about things that cannot or should not be avoided, confronting the fear may be the best option. A method called exposure therapy suggest that fear of spiders should be defused by spending time in a safe environment facing spiders. Numerous studies have documented the benefits of exposure therapy, but there have been a lot of conflicting contentions about which method of exposure is most effective. A study in a recent issue of Behaviour Research and Therapy helps settle the dispute over what method of exposure works best.

The dominant explanation for why method evaluations have given conflicting results is that different methods yield different benefits. Some researchers have alleged that this can be seen when comparing two different types of subject focus during exposure: full focus on the phobia object, and attempt to ignore the phobia object through distraction. The logic behind these two methods is that focusing on the phobia object while safe can help break the association between the object and peril, and learning to distract yourself can teach a coping strategy to use if the object still seems frightening. The prevailing belief has been that focusing reduces physiological responses to the phobia object, while distracting reduces subjective feelings of anxiety.

To evaluate the differences between methods, researcher Barbara Schmid-Leuz brought 63 dental phobics in to face their nightmare for an hour-long exposure session. When tested a week later, both focus and distraction groups showed an equally decreased heart rate during exposure to phobia stimuli. Against expectations, the focus group was the one with the greatest relief of anxious thoughts and subjective feelings.

In the end, both groups had equivalent adherence to a dental plan suggested for six months after the initial exposure; 73% went to the dentist voluntarily even though the average subject had not gone to an appointment in 6.6 years. This suggests that both types of exposure have similar practical benefits, but that focusing on the stimulus has the additional likelihood of reducing anxiety. Further research may reveal whether the benefits from these two methods are mutually exclusive, or whether undergoing one hour of each will confer two stackable benefits. This research is important because facing your fears is always unpleasant, and you don't want to spend more time than you have to sharing a room with a spider.

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