Treatment of specific phobia in children: Are all the components of the phobic response of equal importance?

Davis and Ollendick provide a review on the efficacy of treatments for childhood specific phobias, thereby analyzing to what extent various treatments are effective in altering the three components of the pathological fear response (i.e., subjective, behavioral, physiological). In this commentary, it is noted that there are marked differences in the reactivity of the three response systems among various types of specific phobias and among individuals suffering from this anxiety disorder, suggesting that it is important to tailor the intervention to the individual response pattern of the phobic patient. However, because outcome research indicates that effective treatments for phobias should include exposure-based exercises, a reduction of the behavioral fear response seems to be the primary target of intervention. Furthermore, it is largely unknown to what extent the three-systems model is applicable to childhood phobias. In the meantime, there is emerging evidence demonstrating that developmental processes have a clear impact on children's perception of fear-related symptoms.