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You and Your Computer Can Fight Your Fears Together


There are three main groups of phobias:

  • Specific (simple) phobias. These are the most common and focus on specific objects, such as dogs or snakes.
  • Social phobias. These cause excessive anxiety in social or public situations, like speaking to a group or dating.
  • Agoraphobia. This is the extreme fear of being alone in public places, such as going shopping or even just leaving the house. It causes anxiety when the person is in a place or situation from which it might be difficult or embarrassing to escape.

Although these conditions can be very frightening and disabling, they are also very treatable. Sheryl Jackson, PhD, a clinical psychologist and associate professor at the University of Alabama at Birmingham, says most phobias do not cause a serious disruption in a person's life, and sufferers usually don't seek professional help. Rather, they try to avoid whatever it is that triggers their panic, or they simply endure the distress felt when they encounter it.

Fearfighter isn't the first computer-based phobia program Marks has worked on. In research along with the University of Wisconsin and Harvard University in 1998, Marks conducted a 200-patient, controlled trial of BTSTEPS, a self-help system for the treatment of obsessive-compulsive disorder. As reported in the May 1998 British Journal of Psychiatry, BTSTEPS consists of a manual and a computer-assisted phone system that uses interactive voice response technology. Of the patients tested, 85% completed the self-assessment module and 42% went on to design and complete their own self-treatment guided by the system. Patients improved significantly, about as much as is usual with medication.

Marks says that obsessive behavior in the computer-treated group decreased by an average of three to four hours a day, the same decrease as a group receiving clinician-guided exposure therapy, says Marks. In a group that did not receive BTSTEPS and only received instructions by audiotape, obsessive behavior decreased by only 0.7 hours a day. BTSTEPS also took up 80% less clinician time than normal face-to-face therapy.

Computer-based treatment can fill a gap for patients who are unable to obtain any other help, according to John Greist, PhD, of the University of Wisconsin, who worked on the study with Marks. "And with interactive voice response, patients don't need to have a computer or to travel to a doctor's office," he adds.

However, Greist doesn't see computers replacing traditional therapist-patient relationships. "No treatment works for everyone with a disease, and that will be true for computer-based treatments," says Greist.

Fearfighter only recently became commercially available through a small educational software publisher named Stuart Toole in Birmingham, England.



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