January 20 2004 Experts Try Fast Track Fix for Children With Phobias By RANDI HUTTER EPSTEIN Bugs ruled Brandon Howard s life as long as he could remember One glimpse of a beetle flitting by was enough to send Brandon racing away from his buddies to the safety of home But no more A single three hour treatment session turned Brandon who was 10 then into a friend of beetles In this intensive exposure session a therapist helped Brandon bond with a red striped beetle and conquer his fears So far he s been phobia free for nine months Brandon who is now 11 and lives in Dublin Va is one of 120 children participating in a trial sponsored by the National Institute of Mental Health that is testing a speedy cure for childhood phobias So far investigators from Virginia Tech and Stockholm University in Sweden claim a 75 percent cure rate with follow up of about a year The concept is a CliffsNotes version of traditional exposure therapy the people with phobias are exposed to their worst nightmares until their bodies are too weary to respond with stress But in this trial with children the lessons typically experienced over several sessions are conducted in three hours Brandon said he looked at the beetle in the jar for 20 seconds and needed a break It was awful at first he said And then in the course of a few hours he got closer and closer until the bug was creeping up his arm It was just amazing how you can really heal and not even know it Children s phobias include fear of strangers among infants fear of monsters and fierce animals in toddlers and fear of thunderstorms and bodily injury among older children While some experts believe most children will grow out of these phobias without treatment others see the need for intervention For parents it is best to be calm and not allow children to avoid particular phobias totally many experts say because that can reinforce the child s worries And what can seem like an inconvenience often creates havoc in a household when youngsters refuse to go to school play with friends or go on family outings Parents talk about children who obsess over weather reports lose sleep over the possibility of a fire alarm or refuse to walk to school for fear of encountering a dog Ann Goettman a mother of three in McLlean Va said her formerly outgoing 8 year old suddenly became terrified of thunderstorms It completely changed her personality and disrupted family life Ms Goettman said She didn t want play dates in case it rained I d get calls from the school nurse saying my daughter has stomach pains and I d have to ask Did you hear thunder She was constantly checking the weather map to see if there was a lightning bolt in the picture It consumed her life Ms Goettman s daughter who did not want her name used suffered from a common phobia Her fears faded within five months without professional help but with a lot of reassurance from her parents What type of treatment will work often depends on the child Some experts question whether children have the courage or stamina to withstand a single intense session as Brandon did One treatment session might be good for the highly motivated child said Dr Tamar Chansky director of the Children s Center for O C D and Anxiety in Plymouth Meeting Pa But I think the message for parents is that you have to know your child Is your child a microwave or a crockpot Some kids need more time to stew and simmer And that s O K Most therapists prefer a more relaxed pace teaching a child to behave differently or think differently over several weeks or months Still the institute study s focus on phobic children is helping pave the way for a biologically based concept of emotional development Some scientists speculate that phobias are set off by faulty brain chemistry creating an exaggerated response to say a loud noise or a big dog But instead of a fix itall pill some authorities are looking to cognitive and behavior therapy to fix faulty circuitry and help children cope with stress better when they grow into adults Kim Howard Brandon s mother said her son had been creeped out by everything since he was 3 We live in a rural community with all kinds of weird bugs she said but when all the kids were playing he d just wind up coming home and doing stuff by himself because of a bee spider insect whatever By the end of his treatment at Virginia Tech Brandon s former nemesis a bean size box elder bug became his new pet The really weird thing about the whole deal Mrs Howard said is that he used to be petrified of the dark and thunderstorms I don t know how it all ties together but he is a different more confident kid And there was no hypnosis no medication Dr Thomas Ollendick one of the investigators and a professor of psychology at Virginia Tech said the notion is that a phobia persists because a person has certain catastrophic thoughts about what will happen We expose them to the fear and help them realize what they dread will happen does not truly happen Dr Ollendick said He and his collaborator Dr Lars Goran Ost a professor of psychology at Stockholm University presented preliminary findings on Nov 23 at the meeting of the Association for the Advancement of Behavior Therapy in Boston Therapists say the phobia often has nothing to do with the triggering event Any crisis for the child like the birth of a baby sister or moving to a new home can bring on a fear that may seem to have nothing to do with the initial situation In Freud s day no surprise psychotherapists believed the fears of toddlers and young children represented unconscious sexual urges Little Hans one of Freud s patients in 1909 developed anxiety over horses after a bad fall According to Freud s analysis the horse phobia was a reflection of repressed sexual urges for his mother and aggression against his father said Dr Allan Compton a Los Angeles psychiatrist In the 1920 s Dr John Watson a professor of psychology at Johns Hopkins University argued a radical new theory that phobias could be taught Dr Watson based his notion on a flawed study of one boy Little Albert who was conditioned to fear rabbits The researcher claimed he startled Albert by clanging on an iron rod every time he handed the boy a white rat Like a Pavlovian response Albert would be startled by any white furry creature A close rereading of the study years later though revealed that Albert was never really afraid of rabbits but the facts did not get in the way of a new scientific paradigm Dr Watson s theories formed the
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