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Exposure Therapy Effective for Treating Needle Phobia

Exposure therapy can help decrease avoidance and fear related to needles.

Key points

  • Needle fear and phobia impacts up to 66 million adults in the U.S. and may have prevented people from receiving COVID-19 vaccinations.
  • There are effective immediate and long-term treatments available for needle phobia.
  • In vivo exposure therapy may be effective in treating needle phobia, sometimes in as little as one session.
Virtual reality is one way to provide exposure therapy.
Source: jeshoots/Unsplash

Approximately 11 million to 66 million adults in the US may suffer from a fear or phobia of needles, or trypanophobia (Love & Love, 2021). The number may range so widely because many are hesitant to disclose their phobia due to stigma. Phobia of needles has come to the forefront due to the COVID-19 pandemic and the availability of vaccinations. However, for decades a phobia of needles has caused millions of people to not receive the health care they want and need.

Exposure therapy for phobias, a form of cognitive-behavioral therapy (CBT), consists of directly facing the object or situation that causes you fear. This includes working with a therapist through graduated exposure. If a client had a phobia of snakes, the client would be shown a photo of a snake, then a video of a snake, and may go with the therapist to a zoo where a snake is safely contained. The therapist ensures that the client is feeling comfortable and safe before going to the next level of exposure.

Systematic desensitization is a form of exposure therapy where relaxation exercises are combined with graduated exposure to a feared situation or object. Your therapist may have you do deep breathing exercises as you are shown a picture of a needle. Sometimes your pulse is monitored while you do these exercises to see if you are achieving a relaxation response.

Graduated exposure treatment for needle phobia may not need to be lengthy. A one-session cognitive behavioral therapy treatment for needle phobia was found to be efficient and effective. The treatment consisted of three interactions: a one-hour interview to determine if there was a needle phobia, then a two and a half- to three-hour treatment session exposure therapy was used. The in vivo treatment consisted of images, videos, and the handling of a needle. There was then a 30-minute follow-up appointment (Hiermeier & Mofrad, 2020).

Virtual reality has become a method of providing exposure therapy. It is particularly helpful when the therapist or client isn't able to access the fear-inducing stimuli in person (Meindl, et al., 2019). Virtual reality exposure therapy was also found to be more cost-effective than traditional exposure therapy.

The purpose of in vivo exposure therapy is to help the client break the avoidance of the trigger and learn that he is building up competence around the trigger. In vivo exposure therapy can also help a client process the trauma surrounding a phobia. In the case of needle phobia, the client may have had a traumatic experience when they were in the hospital as a child.

Some avoidance happens because an object or situation is perceived as being dangerous. Avoidance may also occur if an object or situation triggers memories of trauma. Exposure therapy can help teach mastery over a feared object or situation. As you build up your time spent being exposed to the object of your phobia, it is thought that you will become "used to" it and it will not trigger the same sense of fear and dread.

Behavioral activation is another form of exposure therapy. You work with the therapist on goals you can meet for the week, and then at your next appointment, you talk about the steps you took towards reaching those goals. For needle phobia, you and your therapist may set a goal of walking into the lobby of a clinic where you get vaccinations. You may decide you will stand in the lobby for a specific amount of time, like five or 10 minutes. At your next appointment, your therapist may ask you how you felt when you were in the lobby, particularly any physical sensations of fear.

Various formats of exposure therapy have been found to help treat the fear of needles, both in brief sessions and longer treatment.

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Hiermeier, U. M., & Mofrad, L. (2020). Feasibility of one-session treatment for specific needle phobia in an adult IAPT service–a case series. the Cognitive Behaviour Therapist, 13.

Love, A. S., & Love, R. J. (2021). Considering Needle Phobia among Adult Patients During Mass COVID-19 Vaccinations. Journal of Primary Care & Community Health, 12, 21501327211007393.

Meindl, J. N., Saba, S., Gray, M., Stuebing, L., & Jarvis, A. (2019). Reducing blood draw phobia in an adult with autism spectrum disorder using low‐cost virtual reality exposure therapy. Journal of Applied Research in Intellectual Disabilities, 32(6), 1446-1452.

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