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    You and Your Computer Can Fight Your Fears Together


    "The nine steps to recovery can be completed over several weeks," says Marx. Initial sessions educate the user about the nature of anxiety, then the software gathers and stores information about patients and their particular problem, which it can use to graph their progress. Subsequent steps help the user identify triggers that produce the fear and create and assign "homework" tasks. Homework diaries are printed out with details of a "personalized exposure plan." Difficulties that may arise later in treatment are anticipated and dealt with in a troubleshooting section.

    Marks says that when working with 60 people with phobias at the Self-Care Clinic in the Maudsley Hospital, the system saved clinicians up to 67% of their time without hindering their patients' improvement. Results suggested that if adjusted, the system could be used more easily by a wider range of phobias.

    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.

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