Lecture Notes: Exposure Therapy for Phobia Treatment

Introduction

• Mariam Dum, 22, Venezuelan clinical psychologist.
• Lars-Göran Öst from Sweden, an expert in exposure therapy.
• Elf, an American corn snake involved in therapy.
• Context: Mariam has a severe phobia of snakes and will undergo exposure therapy.

Mariam's Phobia

• Specific phobia: fear of snakes.
• Unable to watch movies with snakes, visit zoos, and experiences nightmares.
• Employed at Boston University's Center for Anxiety and Related Disorders.

Exposure Therapy Overview

• Pioneered by psychologist David Barlow.
• Focus on exposure to feared objects to overcome phobias.
• Treatment success often achieved in one week; Öst claims success in three hours.

Therapy Procedure

• Barlow invited Öst to demonstrate brief exposure therapy.
• Mariam to be treated in front of colleagues.
• Exposure therapy involves experiencing fear and realizing it is not dangerous.
• Gradual approach: patient decides on the pace of exposure.
• Aim: Change catastrophic beliefs (Mariam believes she might die from heart failure if unable to escape).

Treatment Process

• Initial interview (45 mins) to identify Mariam's catastrophic belief.
• Anxiety rating: 70-80 out of 100.
• Gradual exposure to snake, Elf.
• No relaxation or deep breathing techniques used initially, except in cases of hyperventilation.

Mariam's Experience

• Anxiety initially high; described as "horrible" but not the strongest reaction.
• Gradual reduction in anxiety as exposure continues.
• Significant improvement noted as Mariam approaches and touches the snake.
• Cognitive changes occur as Mariam learns new information contradicting her fears.

Psychological Principles

• Extinction of anxiety through sustained exposure.
• Positive reinforcement and modeling play roles.
• Öst confident due to research showing high success rates (80% improvement).

Outcome

• Mariam names the snake Elf.
• Anxiety levels decrease to zero by the end of the session.
• Treatment demonstrated to be successful in a three-hour session.

Implications for Treatment

• Consideration of patient choice: three-hour vs. one-week programs.
• Post-treatment recommendations: engage in maintenance activities like watching nature films and visiting zoos.

Follow-up

• Two months post-treatment, Mariam reports improved ability to encounter snakes without panic.

Key Points

• Exposure therapy can be highly effective in treating specific phobias.
• Mariam's successful session highlights the potential for rapid phobia treatment.
• Importance of patient consent and gradual exposure in therapy.
• Öst's method does not rely on traditional relaxation techniques, focusing instead on real-time exposure.