Computer treatment of spider phobia

Exposure-based therapies are considered to be most effective in the treatment of all phobias and have grown to become the psychological treatment of choice. A variable that is combined with exposure-based therapies and enhances phobic improvement is modelling. Past research has shown the mastery technique to be the most effective modelling procedure rather than the coping technique. A putative mechanism for treatment effect may be through the internalization of locus of control. Due to the prevalence of simple phobias, the logistic and economic demands in providing such a treatment make the delivery of therapy to sufferers difficult. Computer administered behaviour therapies represent an innovative solution and have been shown to be effective in controlled trials using subjects with clinical diagnoses.. The present research addresses the limitations of previous instructional computer programs through the development of a simulated computer program for the treatment of spider phobia combining the principles of exposure therapy and modelling techniques. The aims of the study include whether scenario specificity is important in the treatment of specific phobias, whether the program facilitates self-exposure in-vivo, and whether phobic improvement produces a complementary shift in ratings of locus of control. Spider phobics (N=45) were randomly allocated ·to one of three treatment groups: elevator scenario (ES) ; spider scenario (SS); or spider scenario without treatment principles (SSWTP). All subjects completed three computer treatment sessions. Thirty-eight subjects completed the 6 to 12 month follow up. Results showed a significant improvement rate for performance (time taken to reach the maximum score) within each group across the three computer treatment sessions. No significant shift from external to internal locus of control was found within groups following treatment. Computer scenario specificity was found not to constitute an important factor in the treatment of spider phobics as in addition to the elimination of some important treatment principles. Exposure activities were facilitated to a degree by the treatmenl: program and maintained at the follow up. No additional reported exposure activities however, were endorsed during the follow-up period. Reported self-exposure activities were shown to correlate positively with phobic improvement. All groups showed significant phobic improvement following the treatment as measured on a variety of instruments. The methodological limitations of this study are discussed