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Exposure-based cognitive–behavioral therapy is the treatment of choice for specific phobias. A phobia, or an extreme fear of a specific situation or object that results in severe distress or highly avoidant behavior around those objects or situations, can interfere with day-to-day functioning. Using cognitive restructuring strategies with graduated exposure to the feared object, the therapist helps the client to correct anxiety-evoking misappraisals and to replace them with more realistic interpretations and predictions.
In this video, Dr. Tompkins works with a man with a cat phobia. The client's cat phobia has evolved over time, and he has experienced interference in his personal and professional life. Dr. Tompkins supplements exposure-based strategies with cognitive restructuring to help the client to clarify and change his phobic predictions and decrease his avoidant behavior.
Approach
The approach is cognitive–behavioral therapy with an emphasis on exposure-based strategies focused on excessive fears of situations, objects, and physical sensations. Exposure-based cognitive–behavior therapy is the treatment of choice for specific phobias, as well as other anxiety disorders (e.g., social anxiety disorder, obsessive–compulsive disorder, panic disorder, generalized anxiety disorder).
Cognitive interventions and other anxiety management strategies are in the service of graduated exposure and include teaching clients to correct anxiety-evoking misappraisals and replace them with more realistic interpretations and predictions regarding the situations they fear.
In this particular video, the emphasis is on exposure-based strategies supplemented with cognitive restructuring to increase approach behavior and to lessen the avoidance and escape behavior that characterizes phobic disorders.
About the Therapist
Michael A. Tompkins, PhD, is a licensed psychologist, a founding partner of the San Francisco Bay Area Center for Cognitive Therapy, assistant clinical professor at the University of California, Berkeley, and a diplomate and founding fellow of the Academy of Cognitive Therapy.
Dr. Tompkins specializes in the treatment of anxiety disorders and obsessive–compulsive spectrum disorders in adults, adolescents and children. He is the author or coauthor of numerous articles and chapters on cognitive–behavior therapy and related topics, as well as four books, including My Anxious Mind: A Teen's Guide to Managing Anxiety and Panic (with Katherine Martinez) (Magination Press, 2010), which is a Magination Press best seller and earned the 2011 Self-Help Seal of Merit from the Association of Behavioral and Cognitive Therapies and his most recent book, OCD: A Guide for the Newly Diagnosed (New Harbinger, 2012).
Dr. Tompkins serves on the Advisory Board of Magination Press, APA's children's press, and is a supervisor for the Beck Institute for Cognitive Behavior Therapy. He has been featured in The New York Times, The Wall Street Journal and on television (The Learning Channel, Arts & Entertainment) and radio (KQED, NPR).
Dr. Tompkins has presented widely on the topic of cognitive–behavior therapy.
Suggested Readings
Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. H. (2011). Exposure therapy for anxiety: Principles and practice. New York: Guilford Press.
Antony, M. M., Craske, M. G., & Barlow, D. H. (2006). Mastering your fears and phobias (2nd ed.). New York: Oxford University Press.
Antony, M. M., & Watling, M. A. (2006). Overcoming medical phobias: How to conquer fear of blood, needles, doctors & dentists. Oakland, CA: New Harbinger Publications.
Antony, M. M., & McCabe, R. E. (2005). Overcoming animal and insect phobias: How to conquer fear of dogs, snakes, rodents, bees, spiders, and more. Oakland, CA: New Harbinger Publications.
Antony, M. M., Orsillo, S. M., & Roemer, L. (Eds.). (2001). Practitioner's guide to empirically-based measures of anxiety. New York: Springer.
Antony, M. M., & Swinson, R. P. (2000). Phobic disorders and panic in adults: A guide to assessment and treatment. Washington, DC: American Psychological Association.
Craske, M. G., Hermans, D., & Vansteenwegen, D. (2006). Fear and learning: From basic processes to clinical implications. Washington, DC: American Psychological Association.
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