Empirically supported treatments for specific phobia in children: Do efficacious treatments address the components of a phobic response?

Empirically supported treatments for childhood specific phobias are reviewed and critiqued using bioinformational theory (Lang, 1979). Treatments in these trials have been based on different underlying principles of change and have placed different priorities on altering the tri-partite components of the pathological fear response (i.e., physiology, behavior, cognition) as well as the overall subjective experience of fear. Some studies place greater emphasis on altering behavior, others on cognition, and still others on physiology. However, these priorities have not always been attended to in guiding the evaluation of treatment outcome. It is suggested that future studies incorporate, in addition to individuals' subjective fear, a theoretically based multimethod approach to assessment. Research is needed to examine the purported principles of change associated with treatment outcome and to determine the clinical utility of such an approach.