Testing the efficacy of combining emotional writing and in vivo exposure in the treatment of small animal phobias

A number of studies involving in vivo exposure treatments have demonstrated their compelling efficacy in treating individuals with specific phobia (Kamphuis & Telch, 2000; Sloan & Telch, 2002; Rentz, Powers, Smits, Cougle, & Telch, 2003). Moreover, there have also been efforts to establish exposure-augmentation strategies such as providing additional threat-disconfirming information (e.g., Telch et al., 2000; heart-rate feedback) or encouraging counter-phobic behaviors during exposure (Wolitzky, Rellini, & Telch, in preparation). The present study sought to examine whether emotional writing added to a single session in vivo exposure treatment could yield a facilitative effect. A number of studies have demonstrated that individuals could experience a significant improvement in physical/psychological health when writing or talking about personally upsetting experiences. Individuals (N= 56) who met the DSM-IV criteria for specific phobia, small animal type (i.e., spiders and/or snakes) were randomly assigned to one of the following four treatment conditions: (a) Exposure Only (EO); (b) Emotional Writing Only (WO), (c) Exposure with Emotional Writing (E+W); or (d) Waitlist Control (WL). Results revealed that all active treatment groups outperformed the control group and the only one-time emotional writing intervention did not facilitate the previous in vivo exposure treatment for small animal phobia. Theoretical and clinical implications are discussed.