Single Session Phobia Treatment
Conquering your phobias through one focused session
A phobia is an extreme or irrational fear or aversion to a particular object or situation. Phobias can develop at any point in the lifespan from early childhood through advanced age. While many phobias occur after a single incident (e.g., after being stuck in an elevator for several hours), the initial onset of a phobia is not always apparent.
Whether your phobia onset can be tied to a specific experience or seems to have been present for your entire life, cognitive behavioral exposure therapy offers a long term remedy for this problem.
Cognitive behavioral exposure therapy for phobias is an evidence-based treatment, which for some phobias, has even been found to be more effective than treatment sessions with medication alone or treatment sessions with medication and therapy combined (Walker, 2003). In this form of treatment, clients learn cognitive interventions to restructure their fears and catastrophic thoughts, behavioral interventions to manage the distress related to their fears, and will undergo graduated exposure to become desensitized to the feared stimulus.
What is Phobia Exposure Therapy?
Cognitive behavioral exposure therapy for phobias is an evidence-based treatment that has been found to be more effective than treatment with medication alone or treatment with medication and therapy combined (Walker, 2003).
In this form of treatment, clients will learn cognitive interventions to restructure their fears and catastrophic thoughts, behavioral interventions to manage the distress related to their fears, and will undergo graduated exposure to become desensitized to the feared stimulus.
One option for treating phobias is the single session format. Developed by Öst in the 1980s, the one-session treatment (OST) option efficiently and effectively treats a variety of phobias (Li et al., 2020; Öst, Skaret, & ProQuest, 2013). OST for specific phobias is the “boot camp” of exposure therapy, and is highly effective, as it does not allow for the return of fear between sessions (Öst, 1989; Öst, Skaret, & ProQuest, 2013). In fact, OST has shown to produce a favorable response in 99.2% of patients undergoing this form of phobia treatment therapy (Öst, Skaret, & ProQuest, 2013).
While OST is often preferred by many individuals seeking to conquer their greatest fear, few psychologists actually offer this form of treatment (Li et al., 2020). Dr. Tomassetti is highly trained to help determine the best form of exposure therapy to address your concerns, and is qualified to professionally and effectively navigate OST if warranted. Though some phobias are better suited to single session than others (such as needle/injection, insects/small animals, and dental phobias), others are often better suited for multisession phobia treatment therapy (such as fears related to heights, driving, and enclosed spaces). Dr. Tomassetti will discuss this individually with each client to determine the best course of action.
Should it be determined that an individual is an appropriate candidate for OST, the following is what one could expect: After the initial intake appointment, clients typically schedule one, 4- to 8-hour block with Dr. Tomassetti during which exposure interventions are employed. By the end of this extended session, the majority of individuals report that they can tolerate the previously feared object or situation. Clients are then provided with subsequent instructions on how to maintain their progress following OST. These OST sessions are conducted in-person and will take place at Dr. Tomassetti’s Union Square office. During the OST session, it is common for Dr. Tomassetti to accompany clients to other locations, such as a lab/clinic for bloodwork or injections, pet stores to handle animals, or other real life scenarios that had been previously avoided.
Due to the unpleasant nature of confronting phobic stimuli, many clients prefer to “get it over with.” Single session exposure therapy for specific phobias is the “boot camp” of exposure therapy. Following the initial intake appointment, clients typically schedule one, 4-8 hour block with the psychologist. By the end of this extended session, most people report that they are able to tolerate the previously feared object or situation. Clients are instructed in how to maintain their progress after treatment.
Examples of phobias that are well-suited for these extended sessions include:
- Needle/Injection Phobia
- Blood Phobia
- Insect/Animal Phobias
- Dental Phobia
Unsure whether single session phobia treatment is right for you? Contact us and we’ll help you decide!
Frequently Asked Questions
- Needle/Injection Phobia
- Fear of Heights/Flying
- Bodily Fluid (Blood/Vomit) Phobias
- Insect/Animal Phobias
- Dental Phobia
- Fear of deep water
- Fear of thunderstorms
- Social phobias
- Fear of driving
- Fear of enclosed spaces
When an individual is grappling with a phobia, he or she can experience distressing physiological sensations (e.g., heart racing, shortness of breath, dizziness, nausea, etc.) and distressing cognitive experiences (e.g., severe and uncontrollable worry, catastrophic beliefs, and difficulties concentrating) which can lead to ineffective and maladaptive behaviors such as avoiding and escaping from situations, people, places, or things which remind them of the phobia or have the possibility of exposing them to their greatest fear. This can leave a person feeling highly dissatisfied with life, almost as if he or she is trapped and void of the freedom to live life to the fullest. Ultimately, believing one cannot control this fear can lead to intense feelings of anxiety and/or depression, and can even result in hopelessness and helplessness.
Phobia treatment therapy is a highly individualized, evidence-based form of treatment which equips individuals with the skills necessary to overcome their greatest fears. While facing one’s fears requires a great deal of courage, this form of treatment leaves individuals feeling empowered and self-efficacious as they learn how to regain control over a fear that has robbed them of much joy, peace, and confidence.
Phobia treatment therapy begins with a thorough intake evaluation whereby Dr. Tomassetti takes time to learn about your specific fear(s), enabling her to make treatment recommendations (e.g., single vs. multisession treatment) to best address your needs. From there, she will individualize a treatment plan in a collaborative manner, ensuring that you are aware of each treatment step along the way. At the onset of treatment, you will be provided with a rationale for phobia treatment therapy, along with the opportunity to ask Dr. Tomassetti questions about the treatment process. Phobia treatment therapy is a collaborative process whereby Dr. Tomassetti gradually walks you through the exposure process in a planful and controlled manner. As treatment continues, you will experience gradual exposure to your specific fear while being equipped with the skills necessary to reevaluate and reconstruct the false catastrophic beliefs related to the phobia. Opportunities to avoid and/or escape one’s fear(s) will be eliminated during treatment, so that new and healthy appraisals can be established, thus decreasing one’s engagement in catastrophic cognitions and increasing one’s self-efficacy in his or her ability to cope. The following graphic demonstrates how one’s anxiety level changes during an exposure exercise:
There are different types of exposure interventions, and depending on your specific phobia, Dr. Tomassetti will determine which type(s) of exposure will be the most effective. Imaginal exposure is utilized to have clients imagine their fear in great detail, thus exposing them to the thoughts and accompanying physiological sensations and distressing emotions which the thoughts evoke. Interoceptive exposure is employed to expose an individual to uncomfortable bodily sensations which often correspond with intense anxiety and/or panic. In vivo exposure is implemented to expose a patient to their feared stimulus in real life; this form of exposure is most commonly used to treat specific phobias and produces robustly successful outcomes (Choy et al., 2007; MacPhee & Andrews, 2003). For example, if an individual has a spider phobia, then imaginal exposure may be used to guide the person through imagining in detail a spider crawling on his or her arm, interoceptive exposure may be used to trigger the sensation of one’s heart racing, and in vivo exposure could entail actually looking at, or even holding a spider in real life. These three types of exposure can be used in single or multisession phobia treatment therapy. Exposure exercises are employed in a graduated manner with the goal of desensitizing the client to the cognitive, emotional, physiological, and behavioral distress they have learned to experience when triggered by the phobic stimulus.
Prior to your sessions, it may be helpful to make note of any symptoms you experience in relation to the specified phobia. For instance, consider categorizing symptoms into the following four domains: cognitive symptoms (e.g., worries/fears or catastrophic beliefs held regarding the phobia), emotional symptoms (e.g., emotions experienced in relation to the phobia such as anxiety, depression, defeat, disappointment, shame, embarrassment, etc.), behavioral symptoms (e.g., maladaptive behaviors you engage in to avoid/escape facing the phobic situation such as using substances, excessively shopping, canceling plans with loved ones, etc.), and physiological symptoms (e.g., distressing bodily sensations like heart racing/palpitations, shortness of breath, dizziness, nausea, lump in the throat feeling, muscular tension, etc.). In addition to your experienced symptoms, it may be helpful to jot down any particular triggers you experience which activate the identified cognitive, emotional, behavioral, and/or physiological symptoms of distress. Once in your session, be sure to share with Dr. Tomassetti what symptoms and triggers you noted. Doing so will help her gain a thorough understanding of your experiences, and thereby individualize treatment to target your specific concerns.
Dr. Tomassetti welcomes any and all questions. She encourages her clients to not only ask questions during the intake appointment, but to also jot down any questions that come to mind between sessions. Some questions that may be helpful to have answered include, “What are the common challenges faced by those going through phobia treatment therapy?”; “Do you recommend any self-help books or resources related to my specific phobia which could serve as an adjunct to phobia treatment therapy?”; “How can I explain to my trusted loved ones what I’m going through and why I am seeking treatment?”