hierachies

Fear Reduction in Behavior Therapy

• What are Some Most Common Phobias?

  • Specific Phobia: Involves strong fear and avoidance of a particular type of object or situation.

    • Clients typically do not experience panic attacks (known as anxiety attacks) or fear of those attacks (agoraphobia).

    • Exposure to the phobia can lead to feelings of panic.

  • Most Common Phobias Include:

    • Airplane Phobia

    • Animal Phobias

    • Fear of Heights

    • Medical Phobias

    • Elevator Phobia

Anxiety Hierarchies in Adult Clients

• Examples Adapted from: Spiegler & Guevremont (2010)

• Hierarchy for Airplane Phobia (SUDs Ratings):

  1. Making reservations 3 weeks before the flight (5)

  2. Purchasing ticket 10 days before flight (10)

  3. Packing for the trip (15)

  4. Calling the airport for flight status (20)

  5. Driving to the airport (22)

  6. Checking in at the airport (25)

  7. Waiting to board the plane (35)

  8. Boarding the plane (35)

  9. Announcement that the plane is ready for boarding (40)

  10. Sitting down and fastening seatbelt (45)

  11. Plane is cruising in good weather (50)

  12. Plane is climbing to cruising altitude (55)

  13. Plane is taxing to the runway (60)

  14. Plane is taking off (65)

  15. Announcement of preparation for landing (75)

  16. Plane is descending for landing (80)

  17. Plane is banking (85)

  18. Pilot announces turbulence ahead (90)

  19. Plane is touching down on runway (95)

  20. Plane is flying in rough weather (100)

• Hierarchy for Other Fears (SUDs Ratings):

  1. Hearing a siren (5)

  2. Seeing a snake (10)

  3. Swimming in a pool at night (15)

  4. Thinking of witches and ghosts (20)

  5. Thoughts of earthquakes (25)

  6. Thinking about auto crashes (35)

  7. Being alone in a house at night (38)

  8. Climbing on high objects (40)

  9. Thoughts of fire (43)

  10. Driving a car on the highway (45)

  11. Flying in an airplane (48)

  12. Riding as a passenger on the highway (50)

  13. Swimming in the ocean at night (55)

  14. Being around guns (60)

  15. Hearing about a fatal disease (70)

  16. Seeing others in dangerous situations (75)

  17. Watching horror movies (80)

  18. Death of strangers (85)

  19. Death of a close friend/loved one (100)

Sample Hierarchies for Children’s Fears

• Case of "Tammy", Age 8 (Dog Phobia):

  1. Talking about fear of dogs

  2. Seeing movies with dogs

  3. Holding a newborn puppy

  4. Hearing a barking dog from a distance

  5. Visiting a friend with a dog

  6. Seeing a dog from a distance

  7. Close proximity to a dog

  8. Touching a dog with an adult present

  9. Outdoors with a loose dog

  10. Walking a dog

  • Control Scene: Being in a favorite restaurant with family and friends

• Case of "Will", Age 6 (Dog Phobia):

  1. Reading a dog book

  2. Looking at pictures of dogs

  3. Watching cartoons with dogs

  4. Viewing real videos of dogs

  5. Touching a stuffed animal dog

  6. Looking out the window at a caged dog

  7. Observing a loose dog with children

  8. Caged dog in the room

  9. Dog on a leash near him

  • Control Scene: Being safe in bed watching a favorite movie

• Case of "Sally", Age 8 (Arachnophobia):

  1. Drawing a cartoon spider

  2. Seeing a spider cartoon

  3. Viewing a photo of a real spider

  4. Holding a photo of a spider

  5. Holding a plastic spider

  6. Watching a nature video with spiders

  7. Seeing a live spider in a cage

  8. Live spider crawling on the floor (other side of the room)

  9. Live spider crawling next to you

  10. Having a live spider crawling up your arm

  • Control Scene: Baking cookies with Mom.