A new five-year study claims that, with the right support, children could quickly resolve phobias

According to the NHS, an estimated 10 million people in the UK live with a phobia – making it the most common type of anxiety disorder. More than just a feeling of being scared of something, phobias can be all-consuming, occasionally preventing us from going about our days in a healthy and secure way.

Common phobias include spiders, snakes, heights, enclosed spaces, or the dentist – and while some may only react with mild anxiety in the face of their phobia, others may feel completely incapacitated. But now, in a study published in the Journal of Child Psychology and Psychiatry, researchers from the University of York and the University of Sheffield have developed a new approach to treating phobias in children.

Working with 260 children across 27 mental health services in a five-year project, the researchers wanted to understand whether it would be possible to treat a phobia in a single three-hour long session – rather than multiple sessions of cognitive behavioural therapy (CBT), as is the current standard.

The three most common phobias of the children were: fear of animals, vomit and blood, and injury and injections. The treatment sessions included exposure therapy. In the case of a child who had a fear of dogs, the therapist would first direct the child to watch a dog through a window. When the child became ‘bored’ of this, the therapist would coach the child to open the door and, then, gradually get closer to the dog.

“We found that this single three-hour session reduced a child’s phobias and in most cases resolved them, at the same success rate as multiple sessions did,” Professor Lina Gega, director of the Institute of Mental Health Research at York, says. “Our method was based on the premise that the opposite of fear is boredom, and children can become bored quite quickly of a repeated activity.”

As Professor Gega highlights, there are a number of issues with the current approach to treating children’s phobias with multiple therapy sessions. Namely, the child might experience anxiety each week ahead of the session. But also, these sessions intrude on the child’s life, are costly to the NHS, and do not account for limitations to accessing the sessions.

“We often find that with multiple sessions, the drop-out rate is high, so now that we know that just one three-hour session can be just as effective in children, it could open up new opportunities for clinical services to reduce waiting lists, resolve attendance barriers, and save money.”

Resolving a phobia faster has more benefits than might first meet the eye. The study pointed to the fact that severe phobias can often be related to other conditions such as ADHD and depression. It’s therefore possible that resolving the phobia more quickly may enable clinicians to identify other problems, and better support their patients.

“Fears are actually a very rational part of what it means to be human; fears can protect us from getting hurt,” Professor Gega says. “It is only when these fears start to prevent us from doing things in daily life that they can become a clinical issue.

“You can imagine, however, how liberating it is for a child and a parent that after just one therapy session they are able to go to the park without fear of dogs, or go out to eat food with their friends without fear of getting sick, or able to get vaccines that can be life-saving.

“The next stage of this work is to disseminate our findings more widely among health professionals and offer support in how to adapt weeks if not months of CBT into a single condensed session, with the hope that this can become a standard treatment option for children with phobias.”

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