The Evaluation of brief psycho-social interventions to treat specific phobia in Australian youth

For many years, specific phobias were regarded as a common, yet minor psychological problem (Becker et al., 2007). However, with the self-reporting of fears and anxiety on the rise (Twenge, 2000) and the proportion of childhood phobias surpassing the adult population (King, Gullone & Ollendick, 1998) high-quality assistance to alleviate psychological distress associated with specific phobias is sorely needed. Consequently there has been escalating pressure on clinicians to offer services that correlate with society’s fast-paced lifestyle. At present, evidence-based approaches that are applied and evaluated in research settings are usually less conventional amongst clinician’s in the community (Ollendick & March, 2004; Silverman & Kearney, 1992). The evident hiatus between clinical research and clinical practice has underlined the importance to contempory investigations to address this concern. Hence, the overall objective of the following dissertation is to evaluate two promising therapies that support the foundations of Cognitive Behaviour Therapy with the anticipation of reducing the variance between research and practice. Following an examination of the development, maintenance and amelioration of childhood specific phobias to date, the overall aim of the present dissertation is to contribute to the intensive treatment of specific phobias in children and adolescents in an Australian research setting. A total of 43 youths suffering from various phobic types were used in the following three studies. Study I developed and examined the psychometric properties of the Self-Efficacy Questionnaire for Specific Phobias (SEQ-SP). Exploratory factor analysis yielded two reliable subscales labelled Cognitive/Physiological Efficacy and Behavioural Efficacy. Furthermore, preliminary evidence suggested that the SEQ-SP is a highly reliable and valid tool to use as a measure of treatment efficacy and change within phobic response systems (namely, cognitive, behavioural and physiology). Study II randomly assigned youths to one-session treatment exposure (OST), a psycho-education package or a wait list control. A battery of questionnaires was completed pre, post and at the one year follow-up. Results exhibited that both active treatment conditions were superior to the waitlist control at post-treatment. Additionally, no significant differences were found between the two active conditions at post-test or at the one year follow-up. Study III evaluated the prognostic variables (i.e. anxiety sensitivity, maternal psychopathology, phobic acquisition and duration) of OST and psycho-education post-treatment and one year follow-up. With the use of Clinical Significant Improvement (CSI) to determine categories of ‘treatment success’ and ‘treatment failure’, Chi square analyses and t-tests reported small, significant predictors in variables of acquisition (psycho-education at the one year follow-up; p<.05) and anxiety sensitivity using the Childhood Anxiety Sensitivity Index (one-session exposure therapy at post-treatment; p<.05). On the whole, the present findings produced a much needed addition to the OST and psycho-education archives, with clinical implications such as possible dissemination into clinical organisations, schools and other community based curriculums. Manuscript accompanied by CD-ROM titled: The child confidence program : proof of concept, c2009.