Table 1. Characteristics of studies examining the efficacy of an intervention for specific phobias.
| Source | Type of treatment | Specific phobia
type and sample origin |
Treatment condition and sample size | Age
range (M) |
Format of delivery | Primary
outcome measure |
Outcomes | |
|---|---|---|---|---|---|---|---|---|
| 1 | Cai
et al.,
2018 11 |
Psychotherapy | Kinesiophobia
(community) |
1: CBT (psychoeducation and relaxation) (n = 50)
2: Standard care control (n = 50) |
57–74
(65.72) |
4 sessions
- 30 min |
- TSK | Post: 1 > 2
6 months: 1 > 2 |
| 2 | Cougle
et al., 2016 10 |
Psychotherapy | Spiders
(community) |
1: Exposure to contamination (n = 17)
2: Wait-list control (n = 17) |
Not stated
(19.12) |
3 sessions
- 30 min - over 2 weeks |
- BAT
- DPSS-12 - FSQ |
1 week: 1 > 2
Moderated by high levels of general disgust propensity at pre- treatment |
| 3 | Klabbers
et al., 2019 15 |
Psychotherapy | Fear of childbirth
(community) |
1: Haptotherapy (n = 51)
2: Psycho-education via the Internet (n = 39) 3: Care as usual (n = 44) |
Not stated
(32) |
8 sessions
(haptotherapy) - 60 min 8 modules (psychoeducation) - over 8 weeks |
- TES
- W-DEQ - 4DSQ |
6 months: 1 > 2 and 3 |
| 4 | Kowalsky
et al., 2018 23 |
Psychotherapy | Fear of needles
(community) |
1: AMT-RI; applied muscle tension (AMT) during trial one
and respiratory intervention (RI) during trial two (n = 31) 2: RI-AMT; RI during trial one and AMT during trial two (n = 33) 3: No treatment control (n = 31) |
19–55
(23.4) |
1 session | - MFS – Needle
and Blood subscales |
1 > 2 = 3 |
| 5 | Matthews
et al., 2015 24 |
Psychotherapy | Spiders
(community) |
1: Real exposure (online) (n = 14)
2: Hyper-real exposure (online) (n = 11) 3: Control exposure (n = 9) |
Not stated
(26.5) |
8 sessions
- over 1 week |
- FSQ
- BAT - CIDI- specific phobia module |
1 month: 1 = 2 > 3 |
| 6 | Riddle-
Walker et al., 2016 21 |
Psychotherapy | Emetophobia
(clinical) |
1: CBT with exposure (n = 12)
2: Wait-list control (n = 12) |
Not stated
(33.5) |
12 sessions
- 60 min - over 18 weeks |
- EmetQ
- HAI - ASI - PHQ-9 - SDS |
Post: 1 > 2
2 months: 1 > 2 |
| 7 | Rondung
et al., 2018 16 |
Psychotherapy | Fear of childbirth
(community) |
1: CBT (internet-based) (n = 127)
2: Standard care, counselling by midwives (n = 131) |
17–42
(29.6) |
7 modules
- over 8 weeks |
- FOBS | Post: 1 = 2
1 year: 1 > 2 Findings not easily interpreted due to limitations |
| 8 | Rouhe
et al., 2015 13 |
Psychotherapy | Fear of childbirth
(community) |
1: Group psychoeducation with relaxation (n = 131)
2: Control group (n = 240) |
Not stated | 6 sessions
- 120 min - group |
- MAMA
- W-DEQ - EPDS - TES |
3 months: 1 > 2 |
| 9 | Siegel and
Gallagher, 2015 25 |
Psychotherapy | Spiders
(community) |
1: Very brief exposure (VBE), 24-hour BAT (n = 22)
2: Very brief exposure (VBE), immediate BAT (n = 21) 3: Control exposure, 24-hour BAT (n = 21) 4: Control exposure, immediate BAT (n = 22) |
Not stated
(19.4) |
2 sessions
- over 1 week |
- FSQ
- BAT |
1 day: 1 = 2 > 3 = 4 |
| 10 | Tellez
et al., 2015 17 |
Psychotherapy | Dental anxiety
(community) |
1: CBT with psychoeducation, exposure (computer-
based) (n = 74) 2: Wait-list control group (n = 77) |
18–70
(44.7) |
1 session
- 60 min |
- MDAS | 1 month: 1 > 2 |
| 11 | Triscari
et al., 2015 22 |
Psychotherapy | Flying (clinical) | 1: CBT with systematic desensitization (CBT-SD) (n = 22)
2: CBT with eye movement desensitization and reprocessing therapy (CBT-EMDR) (n = 22) 3: CBT with virtual reality exposure therapy (CBT-VRET) (n = 21) |
24–70
(43.52) |
10 sessions
- 120 min |
- FAM
- FAS |
Post: 1 = 2 = 3
1 year: 1 = 2 = 3 |
| 12 | Botella
et al., 2016 27 |
Technology-
assisted therapy |
Spiders/
cockroaches (community) |
1: AR (n = 32)
2: In vivo exposure (n = 31) |
20–70
(31.73) |
1 session
- 180 min - individual |
- BAT | Post: 1 < 2
12 weeks: 1 = 2 24 weeks: 1 = 2 |
| 13 | Freeman
et al., 2018 28 |
Technology-
assisted therapy |
Heights
(community) |
1: VRET (n = 49)
2: TAU (n = 51) |
30–58
(45.51) |
6 sessions
- 30 min - individual |
- HIQ | Post: 1 > 2
4 weeks: 1 > 2 |
| 14 | Gujjar
et al., 2019 29 |
Technology-
assisted therapy |
Dental anxiety
(clinical) |
1: VRET (n = 15)
2: Psychoeducation with information pamphlet (n = 15) |
18–50
(24.15) |
1 session
- 40 min - individual |
- VAS-A
- MDAS - DFS |
Post: 1 > 2
1 week: 1 > 2 12 weeks: 1 > 2 24 weeks: 1 > 2 |
| 15 | Lima
et al.,
2018 30 |
Technology-
assisted therapy |
Storms
(community) |
1: VRET (n = 18)
2: Progressive muscle relaxation + psychoeducation (n = 18) |
Not stated
(27.56) |
1 session
- 60 min - individual |
- SFQ
- BAT |
Post: 1 > 2
4 weeks: 1 = 2 |
| 16 | Miloff
et al., 2019 31 |
Technology-
assisted therapy |
Spiders
(community) |
1: VRET (
VIMSE) (n = 50)
2: In vivo exposure (n = 50) |
>18
(34.05) |
1 session
- 180 min - individual |
- BAT | Post: 1 < 2
12 weeks: 1 = 2 1 year: 1 = 2 |
| 17 | Minns
et al., 2019 32 |
Technology-
assisted therapy |
Spiders
(community) |
1: VRET (n = 38)
2: Wait list (n = 39) |
18–65
(19.27) |
1 session
- 30 min - individual |
- FSQ | Post: 1 > 2 |
| 18 | Yilmaz
Yelvar et al., 2017 33 |
Technology-
assisted therapy |
Kinesiophobia
(community) |
1: VRET physiotherapy (n = 23)
2: Traditional physiotherapy (n = 23) |
Not stated
(49.54) |
10 sessions
- individual |
- TSK | Post: 1 > 2 |
| 19 | Acheson
et al., 2015 34 |
Pharmacotherapy | Spiders
(community) |
1: Exposure + 24 IU oxytocin (n = 10)
2: Exposure + placebo (n = 13) |
Not stated
(1. 26.8, 2. 33.3) |
1 session | - SPQ
- FSQ - BAT |
1 month: 2 > 1 |
| 20 | Meyerbröker
et al., 2018 35 |
Pharmacotherapy | Heights/flying
(clinical) |
1: VRET + 15 mg yohimbine (n = 18)
2: VRET + placebo (n = 18) 3: VRET + 40 mg propranolol (n = 18) |
19–65
(36.6) |
3 sessions
- over 2 weeks |
- WAQ
- AQ - ATHQ - FAM - FAS |
3 months: 1 = 2 = 3 |
| 21 | Raeder
et al., 2019 36 |
Pharmacotherapy | Spiders
(community) |
1: Exposure + 20 mg hydrocortisone (n = 20)
2: Exposure + placebo (n = 23) |
18–65
(1. 22.7, 2. 22.6) |
1 session | - SPQ
- FSQ - SBQ - BAT |
7 months: 2 > 1 |
| 22 | Soeter and
Kindt, 2015 37 |
Pharmacotherapy | Spiders
(community) |
1: Exposure + 40 mg propranolol (n = 15)
2: Exposure + placebo (n = 15) 3: 40 mg Propranolol (n = 15) |
18–32
(21.6) |
1 session | - SPQ
- BAT |
1 year: 1 > 2 = 3 |
| 23 | Soravia
et al., 2014 12 |
Pharmacotherapy | Spiders
(community) |
1: VRET + 20 mg hydrocortisone (n = 11)
2: VRET + Placebo (n = 11) |
20–60
(33.1) |
2 sessions
- group - over 2 weeks |
- FSQ | 1 month: 1 > 2 |
| 24 | Telch
et al.,
2014 38 |
Pharmacotherapy | Enclosed space
(community) |
1: Extinction training + 260 mg methylene blue
2: Extinction training + placebo |
18–36
(19.3) |
1 session | - BAT | 1 month: 2 > 1 |
| 25 | Dreyer-Oren
et al., 2019 39 |
Others | Heights
(community) |
1: CBM (n = 27)
2: CBM + exposure (n = 26) 3: Exposure (n = 26) 4: Control (sham CBM) (n = 28) |
18–67
(23.58) |
2 sessions
- 90 min - individual |
- AQ-anxiety
- HIQ |
Post: 3 > 1 > 2 > 4 |
| 26 | Maples-
Keller et al., 2017 40 |
Others | Flying (community) | 1: Reactivation cue prior to VRE (n = 45)
2: Neutral cue prior to VRE (n = 44) |
21–67
(42.11) |
4 sessions
- individual |
- FFI
- STAI |
Post: 1 = 2
3 months: 1 = 2 1 year: 1 = 2 |
| 27 | Meuret
et al.,
2017 41 |
Others | Blood-injection-
injury |
1: Symptom-associated tension training (SAT) (n = 20)
2: Hypoventilation Respiratory training - HRT (n = 20) 3: Relaxation skills training (RST) (n = 20) |
18–49
(27.9) |
1 session
- 12 min - individual |
- MFS | Post: 1 and 2 > 3 |
| 28 | Notzon
et al., 2015 42 |
Others | Spiders
(community) |
1: iTBS in spider phobics (n = 21), in healthy controls
(n = 19) 2: Sham in spider phobics (n = 20), in healthy controls (n = 23) |
18–65 | 1 session
- 3 min - individual |
- FSQ
- SUDS - HR - SCL |
Post: 1 = 2 |
| 29 | Seinfeld
et al., 2016 43 |
Others | Heights
(community) |
1: VRE with background music (n = 20)
2: VRE without background music (n = 20) |
>18
(1. 27.15, 2. 25.40) |
1 session
- individual |
- SUDS
- APQ - STAI-Y - VR questionnaire - EDA - SCL - ECG |
Post: 1 > 2 |
| 30 | Shiban
et al.,
2017 44 |
Others | Flying (community) | 1: VRE with diaphragmatic breathing (DB) (n = 15)
2: VRE without DB (n = 14) |
20–65
(1. 34.3, 2. 43) |
1 session
- 75 min - individual |
- FFS
- ASI |
Post 1 = 2
1 week 1 = 2 1 year 1 = 2 |
| 31 | Siegel
et al.,
2017 45 |
Others | Spiders
(community) |
1: VBE to masked spiders (n = 30)
2: VBE to masked flowers (n = 30) |
Not stated
(19.6) |
1 session
- individual |
- FSQ
- BAT - SUDS |
Post: 1 > 2 |
| 32 | Steinman
et al., 2014 46 |
Others | Heights
(community) |
1: CBM (n = 27)
2: CBM + exposure (n = 27) 3: Exposure (n = 28) 4: Control (n = 28) |
18–67
(23.58) |
2 sessions
- individual |
- HIQ
- BAT - AQ-anxiety |
Post: 2 > 1 > 3 > 4
1 month: 1 = 2 > 3 = 4 |
| 33 | Telch
et al.,
2017 47 |
Others | Spider/snakes
(community) |
1: Fear reactivation prior to exposure therapy (n = 15)
2: Fear reactivation after exposure therapy (n = 17) |
18–40
(21.31) |
6 sessions
- 3 min - individual |
- BAT | Post: 1 = 2
1 month: 1 > 2 |
4DSQ, Four-Dimensional Symptom Questionnaire; APQ, Autonomic Perception Questionnaire; AQ, Acrophobia Questionnaire; AR, augmented reality; ASI, Anxiety Sensitivity Index; ATHQ, Attitude Towards Heights Questionnaire; BAT, Behavioural Approach/Avoidance Task; CBM, cognitive bias modification; CBT, cognitive behavioural therapy; CIDI, Composite International Diagnostic Interview; DFS, Dental Fear Scale; DPSS-12, Disgust Propensity and Sensitivity Scale-Revised; ECG, electrocardiogram measure; EDA, Electrodermal Activity; EmetQ, Emetophobia Questionnaire; EPDS, Edinburgh Postnatal Depression Scale; FAS, Flight Anxiety Situations Questionnaire; FAM, Flight Anxiety Modality Questionnaire; FFI, Fear of Flying Inventory; FFS, Fear of Flying Scale; FOBS, Fear of Birth Scale; FSQ, Fear of Spiders Questionnaire; HAI, Health Anxiety Inventory; HIQ, Heights Interpretation Questionnaire; HR, Heart Rate; iTBS, Intermittent Theta Burst Stimulation; MAMA, Maternal Adjustment and Maternal Attitudes; MDAS, Modified Dental Anxiety Scale; MFS, Medical Fears Survey; PHQ-9, Patient Health Questionnaire; SBQ, Spider Beliefs Questionnaire; SCL, skin conductance level; SDS, Sheehan Disability Scale; SFQ, Storm Fear Questionnaire; SPQ, Spider Phobia Questionnaire; STAI-Y, State Trait Anxiety Inventory – Form Y; SUDS, Subjective Units of Discomfort; TAU, treatment as usual; TES, Traumatic Event Scale; TSK, TAMPA Scale for Kinesiophobia; VAS-A, Visual Analogue Scale for Anxiety; VBE, very brief exposure; VRE, vancomycin-resistant Enterococci; VRET, virtual reality exposure therapy; WAQ, Weekly Anxiety Questionnaire; W-DEQ, Wijma Delivery Expectancy/Experience Questionnaire.