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Understanding Fears And Phobias

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are comprehensive sources of information for your clients. Concepts are explained in an easily digestible way, with plenty of case examples and accessible diagrams. Understanding Fears and Phobias is designed to help clients with fears and phobias to understand more about their condition.

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A psychoeducational guide. Typically containing elements of skills development.


Languages this resource is available in

  • English (GB)
  • English (US)

Problems this resource might be used to address

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Introduction & Theoretical Background

Everyone feels afraid sometimes. Uncomfortable as it is, fear is an unavoidable part of life. In fact, a little fear can help you stay safe and avoid danger.

However, fear can become so intense, or trouble you so often, that it leads to serious problems. When specific objects, animals, or situations cause intense feelings of fear that are out of proportion to the actual danger, psychologists call it a ‘phobia’. Research indicates that between 3% and 15% of people will develop a phobia at some point in their lives. The good news is that cognitive behavioral therapy (CBT) is an effective psychological treatment for overcoming fears and phobias.

This guide will help you to understand:

  • What fears and phobias are.
  • Why they don’t get better by themselves.
  • Treatments for addressing fears and phobias.

Therapist Guidance

Our ‘Understanding…’ series is designed to support your clients:

  • Scaffold knowledge. The guides are perfect during early stages of therapy to help your clients understand how their symptoms fit together and make sense.
  • Reassure and encourage optimism. Many clients find it hugely reassuring to know there is a name for what they are experiencing, and that there are evidence-based psychological models and treatments specifically designed to help.
  • De-mystify the therapy process. To increase your client’s knowledge of the therapy process and the ingredients that it is likely to involve. If you can help your clients to understand why an intervention is important (think exposure!) it can help encourage them to engage.
  • Signposting. If you’re just seeing a client briefly for assessment, or you have a curious client who wants to know more, these resources can be a helpful part of guiding them to the right service.
  • Waiting time not wasted time. When you’ve assessed someone but their treatment can’t begin right away, psychoeducation can help them learn about how therapy can help while they’re waiting.

Each guide includes:

  • Case examples to help your clients relate to the condition, and to normalize their experiences.
  • Jargon-free descriptions of symptoms, and descriptions of how they might affect your thoughts, feelings, and actions.
  • A symptom questionnaire for screening assessment.
  • An accessible cognitive-behavioral account of what keeps the problem going, or what stops it from getting better.
  • A description of evidence-based treatments for that condition, including an overview of the ‘ingredients’ of a good cognitive behavioral approach.

References And Further Reading

  • Eaton, W. W., Bienvenu, O. J., & Miloyan, B. (2018). Specific phobias. The Lancet Psychiatry, 5, 678-686. DOI: 10.1016/S2215-0366(18)30169-X.
  • Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17, 327–335. DOI: 10.31887/DCNS.2015.17.3/bbandelow.
  • Seligman, M. E. P (1971). Phobias and preparedness. Behavior Therapy, 2, 307-320. DOI:
  • Öst, L. G. (1991). Acquisition of blood and injection phobia and anxiety response patterns in clinical patients. Behaviour research and therapy, 29, 323-332. DOI: 10.1016/0005-7967(91)90067-D.
  • Menzies, R. G., & Clarke, J. C. (1995). The etiology of acrophobia and its relationship to severity and individual response patterns. Behaviour Research and Therapy, 33, 795-803. DOI: 10.1016/0005-7967(95)00023-Q.
  • Olsson, A., & Phelps, E. A. (2007). Social learning of fear. Nature Neuroscience, 10, 1095-1102. DOI: 10.1038/nn1968.
  • Öst, L. G., & Hugdahl, K. (1981). Acquisition of phobias and anxiety response patterns in clinical patients. Behaviour Research and Therapy, 19, 439-447. DOI: 10.1016/0005-7967(81)90134-0.
  • Ashton, M. C., Lee, K., Visser, B. A., & Pozzebon, J. A. (2008). Phobic tendency within the Five-Factor and HEXACO models of personality structure. Journal of Research in Personality, 42, 734-746. DOI: 10.1016/j.jrp.2007.10.001.
  • Hettema, J. M., Neale, M. C., & Kendler, K. S. (2001). A review and meta-analysis of the genetic epidemiology of anxiety disorders. American journal of Psychiatry, 158, 1568-1578. DOI: 10.1176/appi.ajp.158.10.1568.
  • Merckelbach, H., de Jong, P. J., Muris, P., & van Den Hout, M. A. (1996). The etiology of specific phobias: A review. Clinical Psychology Review, 16, 337-361. DOI: 10.1016/0272-7358(96)00014-1.
  • Riskind, J. H., Moore, R., & Bowley, L. (1995). The looming of spiders: The fearful perceptual distortion of movement and menace. Behaviour Research and Therapy, 33, 171-178. DOI: 10.1016/0005-7967(94)E0023-C.
  • Kirk, J., & Rouf, K. (2004). Specific phobias. In J. Benett-Levy, G. Butler, M. Fennell, A. Hackmann, M. Mueller, & D. Westbrook (Eds.), Oxford guide to behavioural experiments in cognitive therapy (pp.161-181). Oxford University Press. 
  • Hofmann, S. G., & Smits, J. A. J. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychology, 69, 621– 632. Doi: 10.4088/JCP.v69n0415.
  • Van Dis, E. A., Van Veen, S. C., Hagenaars, M. A., Batelaan, N. M., Bockting, C. L., Van Den Heuvel, R. M., Cuipers, P., & Engelhard, I. M. (2020). Long-term outcomes of cognitive behavioral therapy for anxiety-related disorders: a systematic review and meta-analysis. JAMA Psychiatry, 77, 265-273. DOI: 10.1001/jamapsychiatry.2019.3986.
  • Wolitzky-Taylor, K. B., Horowitz, J. D., Powers, M. B., & Telch, M. J. (2008). Psychological approaches in the treatment of specific phobias: A meta-analysis. Clinical Psychology Review, 28, 1021-1037. DOI: 10.1016/j.cpr.2008.02.007.
  • Odgers, K., Kershaw, K. A., Li, S. H., & Graham, B. M. (2022). The relative efficacy and efficiency of single-and multi-session exposure therapies for specific phobia: A meta-analysis. Behaviour Research and Therapy, 159, 104203. DOI: 10.1016/j.brat.2022.104203.
  • Choy, Y., Fyer, A. J., & Lipsitz, J. D. (2007). Treatment of specific phobia in adults. Clinical Psychology Review, 27, 266-286. DOI: 10.1016/j.cpr.2006.10.002.
  • Tolin, D. (2012). Face your fears: A proven plan to beat anxiety, panic, phobias, and obsessions. John Wiley and Sons.
  • Zlomke, K., & Davis III, T. E. (2008). One-session treatment of specific phobias: A detailed description and review of treatment efficacy. Behavior Therapy, 39, 207-223. DOI: 10.1016/j.beth.2007.07.003.