Computer-Assisted Exposure Treatment for Flight Phobia: a Controlled Study

Abstract

259This study examines the efficacy of computer-assisted exposure (CAE) treatment in helping to overcome flight phobia and analyzes the role of relaxation and information-related components in the reduction of fear. Fifty flight phobics were randomly assigned to 1 of 3 methods of treatment: (a) CAE; (b) a multicomponent method of treatment of information, relaxation, and CAE (IRCAE); and (c) waiting list control treatment. At the end of the treatment, an actual flight was chartered. The results showed that the first 2 methods of treatments were more effective than the waiting list control treatment. The CAE group showed the greatest reduction in fear. According to data from the IRCAE group, no reduction in flight phobia was observed after the information-relaxation phase. Follow-up data showed that improvements in anxiety self-assessment rates remained constant.Despite the high clinical frequency of flight phobia and its personal and financial repercussions (Wilhelm & Roth, 1997; Van Gerwen, Spinhoven, Diekstra, & Van Dyck, 1997), well-structured treatment programs and controlled studies to evaluate the effects of such programs are scarce, especially when compared with other phobias, although systematic research on the topic has begun to increase.One method of reducing fear of flying that has been most commonly used over the last 30 years is a combination of relaxation techniques and the provision of aeronautical data. Despite its extensive use, the real effectiveness of relaxation training still remains unclear. In Howard, Murphy, and Clarke's (1983) controlled study, relaxation treatment was equally effective as systematic desensitization, flooding, and implosion. In contrast, Denholtz and Mann (1975) found systematic desensitization to flight pictures to be more effective than either relaxation alone or exposure to flight film without relaxation. Moreover, in several controlled trials using relaxation as part of cognitive-behavioral treatments (Beckham, Vrana, May, Gustafson, & Smith,

Computer‐Aided Psychotherapy for Anxiety Disorders: A Meta‐Analytic Review

“…We show the ESs and 95%CIs of the individual control groups in Figure 1. Visual inspection of Figure 1 suggests that the studies by Hassan (1992) and Bornas (2001) were possible outliers. On removing these two studies from the analyses, the ES dropped somewhat (d50.94; 95%CI50.80-1.08 in the fixed-effects model), but heterogeneity fell considerably to a low to moderate level (I 2 536.22).…”

“…Blinding of assessors was reported in seven studies (Bornas, TortellaFeliu, & Llabrés, 2006;Carlbring et al, 2005Carlbring et al, , 2006Ghosh et al, 1988;Greist et al, 2002;Marks et al, 2004). Dropout ranged from 2 to 29% (two studies did not report dropout; Bornas, Tortella-Feliu, Llabrés, & Fullana, 2001;Hassan, 1992). In 11 studies Carlbring, Ekselius, & Andersson, 2003;Carlbring, Westling, Ljungstrand, Ekselius, & Andersson, 2001;Carlbring et al, 2005Carlbring et al, , 2007Greist et al, 2002;Kenardy et al, 2003;Knaevelsrud et al, 2007;Marks et al, 2004; Note.…”

Meta‐Analysis of Computer‐Aided Psychotherapy: Problems and Partial Solutions

“…Palmtop and virtual reality systems had much therapist contact. Our MA of CP (Cuijpers et al, 2009, this issue) found the highest ESs of all in the Hassan (1992) and the Bornas et al (2001) RCTs and a high ES in the Lange RCT; in those studies, however, CP was an add-on to a usual duration of therapist contact in the United Kingdom, even if that contact was just either sitting passively with the patient during CP or reading patients' e-mails and replying by e-mail.…”

“…Let us take examples from Marks et al (2007). An RCT report of Interapy (Lange et al, 2003) did not mention therapist time, but, in fact, Interapy requires a mean of 14 hr of therapist support by e-mail (Ruwaard and Lange, personal communication, June 30, 2008 andJuly 9, 2008), whereas in the RCTs of Hassan (1992) and Bornas, Tortella-Feliu, Llabres, and Fullana (2001), a therapist sat with the patient throughout CP sessions. In these RCTs, a therapist spent as much time with CP patients as is usual during face-to-face exposure therapy in the United Kingdom, so by that the UK criterion the CP saved no therapist time or cost, a vital issue for costeffectiveness.…”

La eficacia de un tratamiento computarizado aplicado a través de Internet para la fobia a volar: Un estudio controlado

“…This issue addresses an interesting question related to improving exposure by creating more realistic exposure scenarios. However, according to , literature has shown that treatment effects are not enhanced by enriching computer-generated exposure environments or creating more sophisticated immersive conditions (Bornas, Tortella-Feliu, & Llabrés, 2006;Bornas, Tortella-Feliu, Fullana, & Llabres, 2001;Mühlberger, Wiedemann, & Pauli, 2003;. Moreover, some authors have suggested that, particularly referring to the flight situation, facing the feared situation in a more realistic way may evoke higher aversiveness levels , which could hinder the treatment's acceptability.…”