The feasibility of using computer-based treatment for specific phobia ; A controlled comparison of computer-based vicarious exposure versus live exposure in the treatment of spider phobia

Literature review An important goal in clinical psychology is the development of safe, cost effective, widely available treatment strategies. This review targets a particular problem, specific phobia, as a reference point in exploring the feasibility of using computers in delivering behavioural treatment for anxiety disorders. This review summaries conventional treatment methods, and evaluates their efficacy and availability. It addresses the advantages as well as the ethical and technical limitations of the use of computers in delivering psychological treatments and reviews current developments and outcome studies. It is concluded that although computer-based treatments are still in their infancy, significant advances have been made in establishing such strategies as an effective, safe and efficient treatment for phobias. Further research to establish computer-based behavioural treatment as a comparable alternative to therapist-directed live exposure for phobias, will allow the efficacy of computer-based treatment to be accurately weighed against the ethical issues. Empirical study The purpose of this study was to examine the efficacy of a computer-based vicarious exposure treatment for spider phobia compared to the standard treatment, therapist-directed live exposure. A total of 45 participants diagnosed with specific phobia (spiders) were included in the study following assessment. Participants were randomly assigned to one of three treatment conditions: computer-based treatment, therapist-directed live exposure treatment or a relaxation placebo treatment. Each treatment group received three 45 minute sessions. Phobic symptomatology was measured at pre treatment and post treatment and at a three month follow-up by the Spider Questionnaire, Fear Questionnaire, Phobic Targets and Work Adjustment Scale and a Behavioural Assessment Test. The results showed that the computer-based treatment was an effective treatment for spider phobia and comparable to therapist-directed live exposure, in producing a significant improvement on all relevant measures of phobic symptomatology. Both the computer-based and live exposure treatments were more effective than the relaxation placebo treatment. The computer-based treatment required substantially less therapist time than that of the live exposure treatment and was rated by participants as a helpful and acceptable treatment. These finding warrant the further development of the computer-based techniques in treating phobic disorders.