Specific Phobia, is characterized by chronic, excessive fear related to exposure to specific objects or situations. Youth with Specific Phobia tend to actively avoid direct contact with the objects or situations that evoke anxiety. Their fear may also be triggered by both the presence or the anticipation of the feared situation. Specific Phobia–Situational Type refers to specific phobias of such things as small confined spaces (i.e., elevators), modes of travel (i.e., cars, planes, buses, trains), and being afraid of the dark. Such kids have difficulty controlling these specific fears, to the point where they are likely to avoid these situations. If they don’t avoid the situation, they are likely to endure such encounters with the feared situation with intense anxiety or distress. This problem must also be present for at least six months before a diagnosis of specific phobia would be considered appropriate. Some children may recognize that their fear is excessive, or out of proportion to the actual risk in the situation, yet the child may still feel intense distress.

Some children with Specific Phobia–Situational Type may exhibit certain themes to their worry or have certain beliefs about the feared situation. For example, kids that are afraid of enclosed places, such as elevators, may believe that they will run out of air, or that they will be unable to escape. Youth that are specifically afraid of the dark may believe that they are much more likely to be “in danger” when they sleep with the lights off. As a coping mechanism, many children with situational specific phobias will frequently avoid such situations, and might avoid thinking about the possibility of the feared outcome. Unfortunately, this avoidance may only result in short-term relief; these kids are likely to continue avoiding such situations and their distress and negative beliefs about the feared situation are likely to increase.

For such youth, physical sensations of anxiety are likely to be quite intense when they are exposed to their feared situation, and some youth may experience panic-like symptoms. A therapist and child will work together to identify the physical responses that they experience (i.e., pounding heart, shaking, difficulty breathing), so that the child can learn that this is part of their anxiety response. Therapy may also involve discussion about the risk of being in particular situations, and the likelihood of being hurt. A goal of therapy is to help the child learn to cope and learn that they are capable of enduring their distress. Children may also learn that their feared situation is less dangerous than they initially believed. A therapist will work with the child on challenges that place them in the feared situation for a period of time. Such challenges may involve sitting in a room with the lights off, for a kid that is afraid of the dark. For a child that is afraid of trains, a therapist and child can ride together on a train, or watch videos of bullet trains. The goal of these challenges is for the child to learn that they can cope with their anxiety in the feared situation, and practice mastery over their anxiety.

References

• Albano, A. M., Chorpita, B. F., & Barlow, D. H. (1996). Childhood anxiety disorders. In E.J. Marsh & R. A. Barkley (Eds.), Child psychopathology (pp. 196-241). New York: Guilford Press.

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• Ollendick, T. H., Raishevich, N., Davis, T. E., Sirbu, C., Ost, L. (2010). Specific phobia in youth: Phenomenology and psychological characteristics. Behavior Therapy, 41, 133-141.