Advanced Therapeutic Solutions for Anxiety provides therapy for the treatment of Specific Phobias.
Specific phobia is a marked and persistent fear or anxiety triggered by the presence of a specific object (e.g., spiders, insects, dogs), natural environment (e.g., heights, storms, water), or health/medical procedures (e.g., fear of blood, injections, transfusions, other medical care, or fear of injury) classified as blood-injection-injury phobia. The fear can also be situational (e.g., airplanes, elevators, enclosed spaces). Other phobias can also be considered a specific phobia. For example, in children, there may be a fear of loud sounds (e.g., balloons popping, glass breaking) or costumed characters (e.g., clowns).
The phobic object or situation almost always triggers immediate fear, and if it can’t be avoided, then it is endured with intense fear or anxiety. The indidividual may recognize that their fear is out of proportion to the actual danger posed, but when they are faced with the object or situation, they still overestimate the danger in that moment, activating the fear response. People with specific phobias actively avoid the phobia. For example, a person who fears flying turns down jobs that require travel. A child with fear of thunderstorms stays in the basement until the thunderstorm passes. A teen afraid of enclosed spaces takes the stairs instead of elevators.
If you are nodding your head reading this, you’re not alone. Specific phobias affect 7%-9% of the US population (1 in 11-14 people), with 5% prevalence in children (1 in 20) and 16% in teens (1 in 6). If you have a specific phobia, chances are you have more than one. About 75% of people with specific phobias fear more than one object or situation, wih the average being three feared objects/situations. A specific phobia can develop after:
- Experiencing or witnessing a traumatic event (e.g., being attacked by a dog), including extensive media coverage of a traumatic event (e.g., plane crashing into the Twin Towers, stories of COVID-19 patients dying)
- Having an unexpected and sudden panic attack in the to-be-feared situation (e.g., a panic attack while riding the bus, getting blood drawn, getting a COVID-19 test)
A lot of times, however, the individual cannot pinpoint the cause. What is more apparent is the active avoidance of the feared object or situation, and the significant anxiety (ranging from anxiety atack to full-blown panic attack) that the phobic stimulus causes when it can’t be avoided.
Specific phobias are treated with exposure therapy with response prevention (ERP). The individual is presented with the phobic stimulus in successive, graduated steps, activating the fear response just enough to retrain the brain, but not overwhelm you. Cognitive-behavioral strategies, such as psychoeducation of the thoughts-emotion-behavior triad (CBT) and mindfulness (ACT) are used to activate the new learning and deepen fear extinction.
Clinical Procedures for Specific Phobia Evaluation and Outpatient Treatment
Free Phone Intake Consultation
Up to 30-min phone consultation so we can hear about your presenting issue, the symptoms you are experiencing, when they started, the severity of symptoms, and if we are the appropriate place for your treatment. The diagnostic intake process is discussed, and your insurance/billing questions are answered. If the treatment you need is within our scope of services, we begin the scheduling process. If it is deemed that we are not the appropriate place, we will provide you with referrals and resources to help you. We want to make sure to connect you with services, and that includes helping you find treatment elsewhere if that's what you need.
CPT CODE: 0
A 90-min diagnostic interview is conducted to assess the presenting problem, symptoms severity (onset, duration, frequency), review areas of life that have been impacted (daily functioning, work, home), collect history, including family history of anxiety or depression, and review what you hope to gain from treatment at ATSA. Specific questions and or measures may be administered during the session for diagnostic purposes.
Starting at 275
CPT CODE: 90791
Treatment Planning Session
A 60-min session to review how the first sessions have felt to you, present hypotheses, and collaborate on a treatment plan. Treatment approaches may include Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP). Treatment dose is also discussed, specifically if weekly 60-min outpatient sessions will be effective, or if intensive doses (e.g., 3-hr sessions) should be considered. Likewise, location of where sessions should occur for most effective outcome is also discussed and planned out. Decisions are made as to whether to start with therapy sessions only, allowing for the future addition of psychopharmacological treatment as an adjunct, or whether to start with combined treatment, (or in rare cases to start with psychopharmacological treatment before CBT, ACT, or ERP).
Starting at 125
CPT CODE: 90837
Exposure Clinic Session
60 min exposure sessions to present you with the phobic stimulus and begin the process of fear extinction. The key to exposure therapy is to activate new learning, which is done by presenting the phobic stimulus, and assisting you to approach (vs avoid) the stimulus, using a hierarchical approach. With repeated exposures, you gain distress tolerance and fear extinction. Additional therapies (e.g., ACT, CBT) may be applied to keep you focused and motivated in preparation for exposures, particularly when exposures become more challenging as we move up the hierarchy. When possible, family members will be included to learn how to facilitate approach coping and reduce enabling avoidance. Our data show that when family members learn how to support you, you are more likely to maintain your treatment gains.
Starting at 125
CPT CODE: 90837
Exposure Therapy in Home or Community Settings
60-min exposure sessions provided in the home or community setting to help transfer treatment gains into these domains. To increase transfer of treatment gains, reduce avoidance of the phobia across settings, and reduce others rescuing you from approaching your phobia (to rescue you from distress), in-vivo and in-situ exposure therapy is most effective. Not only will you develop distress tolerance, new learning, and fear extinction, so will others in these settings, which helps them reduce rescuing and enabling. Home visits are used to help you use skills at home, and Community sessions provide exposure practice in new settings.
Starting at 150 + travel
CPT CODE: 90837