Psychological approaches in the treatment of specific phobias: A meta-analysis ☆ Kate B. Wolitzky-Taylor, Jonathan D. Horowitz, Mark B. Powers 1 , Michael J. Telch ⁎ Laboratory for the Study of Anxiety Disorders, Department of Psychology, The University of Texas at Austin, United States Received 21 August 2007; received in revised form 11 February 2008; accepted 27 February 2008 Abstract Data from 33 randomized treatment studies were subjected to a meta-analysis to address questions surrounding the efficacy of psychological approaches in the treatment of specific phobia. As expected, exposure-based treatment produced large effects sizes relative to no treatment. They also outperformed placebo conditions and alternative active psychotherapeutic approaches. Treatments involving in vivo contact with the phobic target also outperformed alternative modes of exposure (e.g., imaginal exposure, virtual reality, etc.) at post-treatment but not at follow-up. Placebo treatments were significantly more effective than no treatment suggesting that specific phobia sufferers are moderately responsive to placebo interventions. Multi-session treatments marginally outperformed single-session treatments on domain-specific questionnaire measures of phobic dysfunction, and moderator analyses revealed that more sessions predicted more favorable outcomes. Contrary to expectation, effect sizes for the major comparisons of interest were not moderated by type of specific phobia. These findings provide the first quantitative summary evidence supporting the superiority of exposure-based treatments over alternative treatment approaches for those presenting with specific phobia. Recommendations for future research are also discussed. © 2008 Elsevier Ltd. All rights reserved. Keywords: Specific phobia; Meta-analysis; Exposure treatment Contents 1. Introduction ..................................................... 1022 1.1. Treatment utilization ............................................. 1023 1.2. Current treatments for specific phobia .................................... 1023 1.2.1. Exposure approaches ........................................ 1023 1.2.2. Alternative approaches to exposure therapies ............................ 1024 Available online at www.sciencedirect.com Clinical Psychology Review 28 (2008) 1021 – 1037 ☆ Portions of these data were previously presented at the 2005 annual meeting of the Association for Behavioral and Cognitive Therapies. ⁎ Corresponding author. Laboratory for the Study of Anxiety Disorders, Department of Psychology, University of Texas at Austin, 1 University Station A8000, Austin, TX 78712-0187, United States. Tel.: +1 512 475 8488; fax: +1 512 471 6175. E-mail address: telch@austin.utexas.edu (M.J. Telch). 1 Currently at the University of Amsterdam. 0272-7358/$ - see front matter © 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.cpr.2008.02.007