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Discussion in 'Psychology [Psy.D. / Ph.D.]' started by MysteryDiagnosis, May 18, 2017.
And are they best treated by a psychiatrist or psychologist?
They are best treated through systematic desensitization which is a gradual exposure to the feared stimulus paired with relaxation. Any mental health professional should be able to help someone with that. The difficult part is whether or not the patient has sufficient motivation to do what it takes to decrease the phobia. In my years of practice I have yet to meet a patient that did. My wife's fear of heights has decreased since she took up skiing though.
In grad school I treated a lot of specific phobias. I know I had successful cases (at least short term) but of course what comes to mind were my difficult cases.
I, myself, pursued exposure therapy. Still don't *like* my feared thing but substantially reduced avoidance/distress.
It is fascinating how we can work with such different patient populations through our training and how that shapes our views and experience. I have talked to patients about various phobias from time to time and educate the patients on how to reduce the anxiety associated with them if the patient is inclined to, but I have yet to have a case where it was the focus of treatment. Also, maybe the fact that I don't have any specific phobias shapes my approach and interactions with patients. I can see potential positive and negative aspects of that. Good food for thought.
behavior therapies for sure.
From the Canadian Psych association's 2013 summary report of treatment efficacy, "Research on pharmacotherapy options does not support the use of medication as a first line treatment for specific phobia (e.g., Van Ameringen, Mancini, & Patterson, 2009)."
As others have stated, therapy is the first line treatment. Medication may come into play if the person has comorbidities.
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Just wanted to add that many, maybe even most, people with a wide variety of anxiety disorders seem to be treated with various benzodiazepines by their primary care physician or midlevel provider. Often I will see these patients after they have been taking the medication for.years and they are not doing well at all.
We had an in-house anxiety disorders clinic, which skewed my experience. It's super fun to treat. (Meanwhile, we didn't have any, say, neuropsych.) Another reason people should choose their training carefully!
I'm Confused what you are getting at lol
I personally believe phobias are best treated through psychology. From what I've seen it is quite effective when treating phobias to use psychological techniques.
Maybe the difference in population is age. I also treated quite a few folks with phobias in grad school --- but they were all kids. They might not be super into it, but if the parents are motivated, that goes a long way, because at least they show up for sessions, which is more htan I can say for adults I've seen with phobias
I went to a specialty clinic at age 28 for a snake phobia. Six straight hours of exposure in one day and I was “cured”. Eight years later and I still don’t like snakes, but I don’t go into fight or flight when I see one.
If I’m working with someone who needs exposure therapy, I’ll request they stop taking any Benzos if approved by the prescriber. Just gets in the way.
They're best treated by someone who understands principles of learning and behavior and has had supervised training in exposure-based treatments. Usually that would be the psychologist, but there are exceptions.
I would love to see the tax deductions for that guy. “500 snakes @.99 dollars”