Phobias and exposure therapy: ensuring effective treatment

Cognitive-behavioural therapy (CBT) is a widely recognised and evidence-based treatment approach for children, young people and adults presenting with phobias.

It is important to remember that it is quite common for children to develop phobias. These fears can range from the fear of specific animals such as spiders or dogs, to the fear of the dark, heights, or even social situations. Some children may develop phobias related to medical procedures or certain objects. Some children may also develop a phobia of vomit. When a phobia significantly impacts the individual’s daily life, seeking support from a trained cognitive behavioural therapist is a common and recommended step.

CBT focuses on helping individuals understand the connection between their thoughts, feelings, and behaviours in relation to their phobia. CBT involves various techniques, such as identifying and challenging irrational thoughts and gradually exposing individuals to the source of their fear in a controlled and supportive manner, this is called exposure therapy.

Exposure therapy

Exposure treatment asks individuals to confront their fears. This therapy targets the amygdala, the brain region in charge of the "fight-or-flight" response. When the amygdala recognises something as scary, it triggers the fight-or-flight response each time the person encounters their fear. This often results in avoiding scary things or situations. Those avoiding behaviours prevent the amygdala from reconsidering its judgment. In simple terms, when we avoid our phobias at all costs, the brain never learns that we are okay and that we can manage the situation. Exposure therapy aims to rewire the amygdala by showing that the fear is not a genuine threat and that we can cope with those scary things or situations.

Therapists work in a supportive way to enable individuals to develop coping skills and healthy ways of managing their anxiety. By addressing the root causes of their fears and providing practical tools for managing them, CBT can help individuals build resilience and regain a sense of control over their lives.