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Cognitive-behavioral therapies for specific phobia in adults

Randi E McCabe, PhD
Richard Swinson, MD
Section Editor
Murray B Stein, MD, MPH
Deputy Editor
Richard Hermann, MD


Specific phobia is an anxiety disorder characterized by clinically significant fear of a particular object or situation that typically leads to avoidance behavior. Phobic fears include animals, insects, heights, water, enclosed places, driving, flying, and choking or vomiting. Some specific phobias involve responses to medical procedures, such as injections, dental work, or blood. (See "Treatment of specific phobias of clinical procedures in adults".)

Specific phobias are among the most common mental disorders and can be highly disabling [1,2]. However, they are also among the most treatable mental disorders [3-6]. Despite availability of efficacious treatments, the majority of individuals with specific phobias are hesitant to seek treatment [7]. This may be due to lack of knowledge that the phobia is treatable, embarrassment to disclose the phobia to a health professional, accommodation of the phobia through avoidance, or fear of increased anxiety or discomfort in the course of treatment [5].

Psychotherapy for specific phobia in adults is discussed here. The epidemiology, pathogenesis, clinical manifestations, course, and diagnosis of specific phobia in adults are discussed separately. Pharmacotherapy for specific phobia in adults is also discussed separately. Specific phobias and other manifestations of acute anxiety experienced by patients undergoing clinical procedures are also discussed separately. Specific phobia and other fears in children are also discussed separately. (See "Specific phobia in adults: Epidemiology, clinical manifestations, course and diagnosis" and "Pharmacotherapy for specific phobia in adults" and "Acute procedure anxiety in adults: Epidemiology and clinical presentation" and "Overview of fears and phobias in children and adolescents".)


Our approach to selecting treatments for specific phobia in adults is reviewed separately.


Cognitive-behavioral therapy (CBT) for specific phobia consists of cognitive and behavioral strategies designed to alter maladaptive thoughts and behaviors that serve to maintain emotional distress. The principal behavioral approach used in the treatment of specific phobia is exposure, which is combined with other CBT components to treat differing presentations of specific phobia [8].

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Literature review current through: Nov 2017. | This topic last updated: Nov 30, 2017.
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