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Research and evidence

Exposure-based treatment has been studied for decades, in person and, more recently, by phone, internet programme and live video. ReHabituation supports therapists who deliver it by video from a laptop. This page lists published work on that kind of treatment and says what Rephobia's own research has looked at. The studies describe the treatment in general. They do not describe ReHabituation's results.

The foundations of exposure therapy

  1. Öst, L.-G. (1989). One-session treatment for specific phobias. Behaviour Research and Therapy, 27(1), 1-7. doi.org/10.1016/0005-7967(89)90113-7 (opens in a new tab)

    The original description of one-session exposure treatment for specific phobias.

  2. Wolitzky-Taylor, K. B., Horowitz, J. D., Powers, M. B., and Telch, M. J. (2008). Psychological approaches in the treatment of specific phobias: a meta-analysis. Clinical Psychology Review, 28(6), 1021-1037. doi.org/10.1016/j.cpr.2008.02.007 (opens in a new tab)

    Pools trials of psychological treatments for specific phobias, including exposure-based treatment.

  3. Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., and Vervliet, B. (2014). Maximizing exposure therapy: an inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23. doi.org/10.1016/j.brat.2014.04.006 (opens in a new tab)

    Sets out the inhibitory learning account of exposure and practical ways to apply it.

  4. Foa, E. B., Hembree, E. A., and Rothbaum, B. O. (2007). Prolonged Exposure Therapy for PTSD: Therapist Guide. Oxford University Press. doi.org/10.1093/med:psych/9780195308501.001.0001 (opens in a new tab)

    The therapist manual for prolonged exposure for PTSD.

Exposure therapy by live video

  1. Gros, D. F., Morland, L. A., Greene, C. J., Acierno, R., Strachan, M., Egede, L. E., and others (2013). Delivery of evidence-based psychotherapy via video telehealth. Journal of Psychopathology and Behavioral Assessment, 35(4), 506-521. doi.org/10.1007/s10862-013-9363-4 (opens in a new tab)

    Reviews research on delivering evidence-based psychological therapies over video.

  2. Acierno, R., Knapp, R., Tuerk, P., Gilmore, A. K., Lejuez, C., Ruggiero, K., and others (2017). A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: in person versus home-based telehealth. Behaviour Research and Therapy, 89, 57-65. doi.org/10.1016/j.brat.2016.11.009 (opens in a new tab)

    A randomised trial comparing prolonged exposure for PTSD in person with the same treatment by video to people's homes.

  3. Bouchard, S., Paquin, B., Payeur, R., Allard, M., Rivard, V., Fournier, T., and others (2004). Delivering cognitive-behavior therapy for panic disorder with agoraphobia in videoconference. Telemedicine Journal and e-Health, 10(1), 13-25. doi.org/10.1089/153056204773644535 (opens in a new tab)

    Compares CBT for panic disorder with agoraphobia delivered by videoconference with the same treatment in person.

  4. Vogel, P. A., Launes, G., Moen, E. M., Solem, S., Hansen, B., Håland, Å. T., and others (2012). Videoconference- and cell phone-based cognitive-behavioral therapy of obsessive-compulsive disorder: a case series. Journal of Anxiety Disorders, 26(1), 158-164. doi.org/10.1016/j.janxdis.2011.10.009 (opens in a new tab)

    A case series of CBT with exposure for OCD delivered by videoconference and mobile phone.

Remote and internet-delivered treatment: phobias

  1. Andersson, G., Waara, J., Jonsson, U., Malmaeus, F., Carlbring, P., and Öst, L.-G. (2009). Internet-based self-help versus one-session exposure in the treatment of spider phobia: a randomized controlled trial. Cognitive Behaviour Therapy, 38(2), 114-120. doi.org/10.1080/16506070902931326 (opens in a new tab)

    Compares an internet self-help programme with one-session exposure for spider phobia.

  2. Andersson, G., Waara, J., Jonsson, U., Malmaeus, F., Carlbring, P., and Öst, L.-G. (2013). Internet-based exposure treatment versus one-session exposure treatment of snake phobia: a randomized controlled trial. Cognitive Behaviour Therapy, 42(4), 284-291. doi.org/10.1080/16506073.2013.844202 (opens in a new tab)

    Compares internet-based exposure treatment with one-session exposure for snake phobia.

Remote and internet-delivered treatment: OCD

  1. Lovell, K., Cox, D., Haddock, G., Jones, C., Raines, D., Garvey, R., and others (2006). Telephone administered cognitive behaviour therapy for treatment of obsessive compulsive disorder: randomised controlled non-inferiority trial. BMJ, 333(7574), 883. doi.org/10.1136/bmj.38940.355602.80 (opens in a new tab)

    A UK trial comparing CBT with exposure and response prevention by telephone with the same treatment face to face.

  2. Andersson, E., Enander, J., Andrén, P., Hedman, E., Ljótsson, B., Hursti, T., and others (2012). Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial. Psychological Medicine, 42(10), 2193-2203. doi.org/10.1017/S0033291712000244 (opens in a new tab)

    A randomised trial of therapist-guided internet CBT with exposure and response prevention for OCD.

  3. Wootton, B. M. (2016). Remote cognitive-behavior therapy for obsessive-compulsive symptoms: a meta-analysis. Clinical Psychology Review, 43, 103-113. doi.org/10.1016/j.cpr.2015.10.001 (opens in a new tab)

    Pools studies of CBT for OCD delivered remotely, including by video, telephone and internet.

Remote and internet-delivered treatment: PTSD

  1. Lewis, C., Roberts, N. P., Simon, N., Bethell, A., and Bisson, J. I. (2019). Internet-delivered cognitive behavioural therapy for post-traumatic stress disorder: systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 140(6), 508-521. doi.org/10.1111/acps.13079 (opens in a new tab)

    Pools trials of internet-delivered CBT for PTSD.

  2. Bisson, J. I., Ariti, C., Cullen, K., Kitchiner, N., Lewis, C., Roberts, N. P., and others (2022). Guided, internet based, cognitive behavioural therapy for post-traumatic stress disorder: pragmatic, multicentre, randomised controlled non-inferiority trial (RAPID). BMJ, 377, e069405. doi.org/10.1136/bmj-2021-069405 (opens in a new tab)

    A UK multicentre trial comparing guided internet-based trauma-focused CBT with face-to-face therapy.

Remote and internet-delivered treatment: social anxiety and panic

  1. Andersson, G., Carlbring, P., Holmström, A., Sparthan, E., Furmark, T., Nilsson-Ihrfelt, E., and others (2006). Internet-based self-help with therapist feedback and in vivo group exposure for social phobia: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 74(4), 677-686. doi.org/10.1037/0022-006X.74.4.677 (opens in a new tab)

    A randomised trial of internet-based self-help with therapist feedback, plus group exposure sessions in person, for social anxiety.

  2. Carlbring, P., Bohman, S., Brunt, S., Buhrman, M., Westling, B., Ekselius, L., and others (2006). Remote treatment of panic disorder: a randomized trial of internet-based cognitive behavior therapy supplemented with telephone calls. American Journal of Psychiatry, 163(12), 2119-2125. doi.org/10.1176/ajp.2006.163.12.2119 (opens in a new tab)

    A randomised trial of internet-based CBT with weekly telephone calls for panic disorder.

Remote and internet-delivered treatment: across conditions

  1. Carlbring, P., Andersson, G., Cuijpers, P., Riper, H., and Hedman-Lagerlöf, E. (2018). Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cognitive Behaviour Therapy, 47(1), 1-18. doi.org/10.1080/16506073.2017.1401115 (opens in a new tab)

    Pools trials that compared internet-based and face-to-face CBT directly.

Guidance therapists work to

  1. NICE CG31 (2005). Obsessive-compulsive disorder and body dysmorphic disorder: treatment. nice.org.uk/guidance/cg31 (opens in a new tab)

  2. NICE CG113 (2011). Generalised anxiety disorder and panic disorder in adults: management. nice.org.uk/guidance/cg113 (opens in a new tab)

  3. NICE CG159 (2013). Social anxiety disorder: recognition, assessment and treatment. nice.org.uk/guidance/cg159 (opens in a new tab)

  4. NICE NG116 (2018). Post-traumatic stress disorder. nice.org.uk/guidance/ng116 (opens in a new tab)

NICE has no guideline dedicated to specific phobia.

The Lanyon Building at Queen's University Belfast

Rephobia's own research

Rephobia Limited's earlier study with Queen's University Belfast was a non-clinical study with 44 participants: volunteers who were not patients. Each person tried a fear-of-heights scenario in two forms, interactive virtual reality and a matched 360-degree video, in a crossover design. The study compared their anxiety, sense of presence and experience between the two. Rephobia Limited commissioned and funded the study and built both environments. Researchers at Queen's University Belfast (Jessica Cushnan, Tom Van Daele and Paul Best) designed and ran it independently. A paper is being prepared for publication. The study was not a clinical trial and makes no claim about treatment outcomes. Rephobia's earlier work used virtual reality, and ReHabituation supports therapy by video.

If you know of published work that belongs on this page, email hello@rehabituation.com.

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