Claustrophobia: A Clinician’s Guide to the Fear of Enclosed Spaces, Its Causes, Symptoms, Treatment with Exposure Therapy, and the Relationship Between Phobia and Substance Use

What claustrophobia is in the DSM-5 framework of specific phobia, the typical symptoms during exposure to enclosed spaces, the underlying causes including conditioning and biological vulnerability, why exposure therapy is the gold-standard treatment, when medications are appropriate, the relationship between untreated anxiety and substance use, and how to recognise when professional treatment is needed.

Clinically reviewed by Dr. Ponlawat Pitsuwan, Physician and Addiction Medicine Specialist, Phuket Island Rehab.

Claustrophobia is the fear of enclosed or confined spaces, classified in the DSM-5 as a specific phobia of the situational type. The condition affects approximately 4 to 7 percent of the general population at some point in life, with women more commonly affected than men. The symptoms occur during exposure to enclosed spaces including elevators, MRI scanners, small rooms, crowded transportation, tunnels, and similar environments, and include intense fear, rapid heart rate, sweating, shortness of breath, chest tightness, trembling, dizziness, nausea, fear of suffocating, fear of losing control, and the urge to escape the space immediately. The fear is recognised by the person as excessive or out of proportion to the actual danger but cannot be controlled by reasoning. The cause is multifactorial and includes prior traumatic experiences in enclosed spaces (classical conditioning), observational learning from watching others react with fear, family history suggesting genetic vulnerability, and amygdala-based threat detection that has been miscalibrated. Treatment is highly effective and centres on exposure therapy, in which the person gradually approaches feared situations under structured guidance until the fear response extinguishes. Cognitive behavioural therapy addresses the catastrophic thoughts that maintain the fear. Medications including SSRIs and short-term benzodiazepines can support treatment but are not the primary intervention. The relationship between untreated phobias and substance use disorders is meaningful, with many people using alcohol or benzodiazepines to manage phobia-related situations and developing dependence over time.

What claustrophobia is and how it is diagnosed

Claustrophobia is the marked fear or anxiety about enclosed or confined spaces. The DSM-5 classifies claustrophobia under specific phobia, situational type, alongside other situation-bound phobias including fear of flying (aviophobia), fear of driving (vehophobia), fear of bridges (gephyrophobia), and fear of heights (acrophobia). The diagnostic criteria require that the fear or anxiety is out of proportion to the actual danger posed by the situation, that exposure to the situation almost always provokes immediate fear or anxiety, that the situation is actively avoided or endured with intense fear, that the fear, anxiety, or avoidance is persistent (typically six months or more), that it causes clinically significant distress or impairment, and that it is not better explained by another mental disorder.

The specific situations that provoke claustrophobia include elevators, particularly slow or crowded ones, MRI scanners (which produce some of the most severe acute reactions because of the enclosed nature of the bore and the difficulty of immediate escape), small rooms without windows, dressing rooms, photo booths, crowded transportation including aeroplanes, trains, and buses, tunnels of any kind including road tunnels and underground transport, cave systems and underground spaces, and any tight enclosed area where the person feels they cannot easily escape. The severity varies between individuals, with some people having mild discomfort that they can tolerate and others having severe panic that prevents them from entering any enclosed space.

The lifetime prevalence of claustrophobia in the general population is estimated at 4 to 7 percent, making it one of the more common specific phobias. Women are affected approximately twice as often as men, a sex difference that is consistent across most specific phobias. The condition typically develops in childhood or early adulthood, often after a specific triggering experience, though some people cannot identify any specific trigger and describe the fear as having always been present. The condition can persist throughout life if untreated, with the severity sometimes fluctuating in response to life stresses and circumstances.

Claustrophobia is distinct from but can overlap with other anxiety conditions. Panic disorder involves recurrent unexpected panic attacks that can occur in any setting, while claustrophobia involves panic specifically triggered by enclosed spaces. Agoraphobia involves fear of multiple situations from which escape might be difficult, often including but not limited to enclosed spaces. Post-traumatic stress disorder can include fear of specific situations associated with the trauma. Generalised anxiety disorder involves persistent worry about multiple life domains. The differential diagnosis matters because treatment approaches vary somewhat across these conditions.

Symptoms during exposure to enclosed spaces

The symptoms of claustrophobia during exposure to a feared situation involve both psychological and physical features that develop rapidly and can be intensely distressing. The psychological symptoms include intense fear of the enclosed space, fear of suffocating or being unable to breathe, fear of losing control, fear of dying, fear of going crazy, the strong urge to escape immediately, and the cognitive narrowing in which the person becomes unable to think about anything other than the immediate situation and how to get out of it. The thoughts can include catastrophic predictions including that the elevator will fall, the tunnel will collapse, or the MRI machine will malfunction with the person trapped inside.

The physical symptoms are those of the fight-or-flight response activated by the threat detection system. The heart rate increases, often to 100 to 150 beats per minute. Blood pressure rises. Breathing becomes rapid and shallow, with some people hyperventilating to the point of lightheadedness, tingling in the hands and around the mouth, and the paradoxical feeling of not being able to get enough air despite breathing more rapidly than normal. Sweating increases. Hands and feet feel cold and clammy as blood is shunted to large muscle groups. Trembling or shaking occurs. The chest feels tight. Nausea, abdominal discomfort, and sometimes urgent need to use the bathroom develop.

Sensory changes accompany the panic response. The visual field can narrow, with the person describing tunnel vision in which only the immediate central field is clear and the peripheral vision feels blurry. Sounds may become muffled or unusually clear. The sense of time becomes distorted, with the few minutes of exposure feeling much longer. Some people experience derealisation, the feeling that the surroundings are not quite real, or depersonalisation, the feeling of being detached from oneself or watching from outside. These dissociative symptoms can be themselves frightening and can reinforce the catastrophic thinking.

The acute panic response peaks within 5 to 10 minutes of exposure and gradually subsides over the subsequent 20 to 30 minutes, even without escape. Without intervention to interrupt the cycle, however, most people in claustrophobic panic do escape the situation, which provides immediate relief but reinforces the avoidance pattern that maintains the phobia long-term. The relief from escape is part of why the phobia persists; the brain learns that escape resolves the fear, even though the fear was disproportionate to the actual situation.

Between exposures, the person often experiences anticipatory anxiety about future encounters with enclosed spaces. The anticipatory phase can produce its own symptoms including worry, sleep disturbance, irritability, and avoidance of plans that might involve feared situations. Some people structure their lives substantially around avoidance, taking stairs rather than elevators, avoiding air travel, refusing medical imaging that requires MRI scanning, or moving to homes and workplaces that minimise exposure. The accumulated avoidance can be substantially impairing and is one of the main features that distinguishes clinical claustrophobia from ordinary discomfort with enclosed spaces.

What causes claustrophobia

The causes of claustrophobia involve multiple converging factors rather than a single mechanism. Classical conditioning through traumatic experience is the clearest pathway when it can be identified. A person who became stuck in an elevator for an extended period, who was trapped in a confined space during an accident, who experienced a panic attack in a crowded situation, or who had any other unpleasant experience in an enclosed space can develop a conditioned fear response to similar situations afterward. The conditioning can be acquired through a single intense experience or through repeated minor experiences that gradually establish the association.

Observational learning is a second pathway, particularly important in children. A child who watches a parent react with fear to elevators, MRI scanners, or other enclosed spaces can develop similar fear responses through modelling. Family clusters of phobias are common and reflect both genetic vulnerability and observational learning across generations. Cultural messaging including news coverage of disasters in enclosed spaces, films portraying terrifying experiences in confined environments, and stories of being trapped can contribute to the development of phobic responses even in people without direct or observed traumatic experience.

Biological vulnerability plays a substantial role. Twin studies and family studies have demonstrated heritability of specific phobias including claustrophobia, with first-degree relatives having approximately three times the risk of phobia compared with the general population. The biological vulnerability likely involves variations in amygdala reactivity, hypothalamic-pituitary-adrenal axis function, and the threshold for triggering the fight-or-flight response. Individuals with naturally higher amygdala reactivity may be more prone to developing phobias when they encounter relevant triggering experiences.

Evolutionary perspectives suggest that some fear of enclosed spaces may be biologically prepared, meaning that the human brain is more easily conditioned to fear enclosed spaces than to fear arbitrary stimuli. The argument is that enclosed spaces in the ancestral environment carried real dangers including predation, suffocation, and being trapped, and that the readiness to fear such spaces conferred survival advantage. The preparedness model explains why specific phobias cluster around evolutionarily relevant stimuli (heights, animals, blood, enclosed spaces) rather than being randomly distributed across the environment, and why the fear response to these stimuli is often disproportionate to the modern actual risk.

Developmental factors contribute to the timing and form of claustrophobia. Childhood experiences of being constrained, including being held down, being trapped, or being unable to escape, can lay foundations for later phobic responses. Childhood medical procedures involving enclosed spaces (early experiences with MRI scanners, CT machines, or being held still for medical procedures) can produce conditioned responses that emerge later. The age of typical onset (childhood to early adulthood) reflects the developmental period during which conditioning is particularly effective.

Exposure therapy: the gold-standard treatment

Exposure therapy is the most well-established and effective treatment for claustrophobia and other specific phobias. The treatment involves systematic exposure to feared situations under structured guidance, with the person learning through repeated experience that the feared situation does not produce the catastrophic outcomes that the brain has been predicting and that the fear response gradually diminishes with continued exposure. The technique is based on the principle of extinction learning, in which the brain updates its prediction about a stimulus through experience that contradicts the predicted threat.

A typical course of exposure therapy for claustrophobia involves 8 to 12 sessions delivered by a therapist trained in cognitive behavioural therapy or behavioural therapy. The early sessions focus on psychoeducation about anxiety and the rationale for the treatment, development of a fear hierarchy in which the person ranks feared situations from least to most distressing, and preparation for the exposure work. The middle sessions involve graduated exposure, beginning with situations low on the hierarchy and progressing toward more challenging situations as the person develops mastery. The final sessions consolidate the gains and develop maintenance plans for continued exposure after treatment ends.

Imaginal exposure is sometimes used as a preliminary step or as a complement to in vivo exposure. The person vividly imagines the feared situation while in the therapist’s office, with the imagining producing some of the same physiological responses as actual exposure. The technique allows practice with the cognitive and emotional elements of exposure before the in vivo work begins. Virtual reality exposure, increasingly available since the 2010s, allows more realistic simulation of feared situations within the office setting and has been shown to be effective for some claustrophobic patients.

The in vivo exposure work for claustrophobia might progress through situations such as standing in a small room with the door open, then with the door closed, then for progressively longer periods. The hierarchy might extend to riding in elevators (first with another person, then alone, first for one floor, then for multiple floors), entering MRI-simulator environments, taking short tunnel drives, and progressing to whatever specific situation the person needs to be able to tolerate for their life. Each exposure continues until the anxiety has substantially decreased from the peak, demonstrating to the brain that the feared outcome does not occur.

The success rate of exposure therapy for specific phobias including claustrophobia is high, with meta-analyses showing approximately 80 percent of patients achieving significant improvement and approximately 50 percent achieving full resolution of the phobia. The treatment effects are durable, with most patients maintaining their gains for years after treatment ends. The relatively brief duration of treatment (8 to 12 sessions over 2 to 3 months) and the high success rate make exposure therapy one of the most efficient interventions in mental health.

Cognitive behavioural therapy and the cognitive component

Cognitive behavioural therapy for claustrophobia combines the exposure component with explicit work on the catastrophic thoughts that maintain the fear. The cognitive work helps the patient identify the specific thoughts that fire during exposure (I cannot breathe, I am going to suffocate, the elevator is going to fall, the MRI machine will malfunction and I will be trapped), evaluate these thoughts against evidence (How often do elevators actually fall? What are the actual safety statistics?), and develop more accurate predictions about the feared situations. The cognitive work supports the exposure work by giving the patient alternative thoughts to engage with when the catastrophic ones emerge.

Specific cognitive techniques include thought records, in which the patient writes down the situation, the automatic thoughts, the emotional and physical reactions, and develops more balanced alternative thoughts. Behavioural experiments test specific predictions through structured exposure (How long can I actually hold my breath? Does breathing more slowly during the exposure help or hurt?). Coping statements developed during therapy can be used during difficult exposures (This feeling will pass. I have done this before and survived. The fear is bigger than the danger). The combination of cognitive and behavioural work produces stronger outcomes than either alone for many patients.

Acceptance and commitment therapy is a newer cognitive-behavioural approach that takes a somewhat different stance toward the anxiety. Rather than attempting to reduce the anxiety through challenging thoughts, ACT focuses on accepting the anxiety as part of the experience while continuing to engage with valued activities. The patient learns to tolerate the discomfort of anxiety rather than seeking to eliminate it, with the paradoxical effect that the tolerance often reduces the anxiety over time. ACT has growing evidence for effectiveness in anxiety disorders including specific phobias.

Mindfulness-based approaches teach the patient to observe the anxiety as it arises and passes without acting on it, similar in some ways to the urge surfing technique used in addiction treatment. The patient learns to recognise the physical sensations of fear without interpreting them as catastrophic and to allow the wave of anxiety to rise and fall without escape behaviour. Mindfulness practice between sessions builds the capacity for this kind of observation, which can be applied during real exposures to enclosed spaces.

Medications for claustrophobia

Medications are not the primary treatment for claustrophobia but can play supporting roles in some situations. The SSRI antidepressants including sertraline, paroxetine, escitalopram, and fluoxetine reduce the underlying anxiety vulnerability and can support the work of exposure therapy. The effect develops over 4 to 6 weeks of consistent dosing. The medications do not eliminate the phobia by themselves but can make exposure therapy easier and can prevent the interference of background anxiety with the therapeutic work. SSRIs are typically considered for patients with significant comorbid anxiety or depression, less so for patients with isolated specific phobia.

Short-term benzodiazepines including alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium) can be used for acute management of specific feared situations that cannot be avoided. A patient who needs an MRI scan for medical evaluation but who has severe claustrophobia might take a single dose of alprazolam 30 to 60 minutes before the procedure to allow the scan to proceed. The use is appropriate for occasional discrete situations but is problematic if it becomes a routine approach because of the dependence risk and the interference with the extinction learning that exposure work requires.

Beta-blockers including propranolol can reduce the physical symptoms of anxiety (rapid heart rate, trembling) without producing the cognitive effects of benzodiazepines. They are sometimes used for performance anxiety and can be useful for some patients with claustrophobia, particularly when the physical symptoms are the most distressing aspect of the response. The medications do not address the underlying phobia and are typically used as adjuncts to behavioural treatment rather than as standalone interventions.

Buspirone is a non-benzodiazepine anxiolytic that can be considered for chronic anxiety management, including in patients with anxiety disorders that include specific phobia. The medication does not produce the dependence problems of benzodiazepines and can be used long-term. The effect is modest and emerges over weeks of dosing. Buspirone is generally considered for patients with generalised anxiety more than for isolated specific phobia, but can have a role in some treatment plans.

Claustrophobia and substance use

The relationship between claustrophobia and substance use is clinically important and underappreciated. Many people with untreated claustrophobia and other specific phobias use alcohol or benzodiazepines to manage the situations that they cannot avoid. The pattern often begins with occasional use for specific occasions (a glass of wine before getting on a plane, an alprazolam before an MRI scan) and can progress to more frequent use as the person encounters more feared situations or as the use generalises to other anxiety contexts. The self-medication of phobias is one of the pathways into alcohol use disorder and benzodiazepine use disorder.

The interaction between phobia and substance use can be mutually reinforcing. The substance reduces the acute anxiety in the feared situation, which provides immediate relief but interferes with the extinction learning that would otherwise occur with repeated exposure. The phobia therefore persists rather than diminishing with experience. The repeated substance use to manage the phobia produces tolerance and dependence over time. Withdrawal from the substance produces additional anxiety that adds to the phobic anxiety, making the next situation feel even more difficult. The cycle can produce significant functional impairment over years.

Treatment of co-occurring phobia and substance use disorder requires integrated attention to both. Treating only the substance use without treating the phobia leaves the underlying driver of the use in place and produces high relapse rates. Treating only the phobia without addressing the substance use is difficult because the substance use interferes with the exposure work and because the substance use can produce its own anxiety that overlaps with the phobic anxiety. The integrated approach typically involves stabilisation of any acute substance use issues first, followed by structured exposure therapy for the phobia delivered alongside ongoing addiction treatment.

Phuket Island Rehab provides residential addiction medicine treatment for international patients with co-occurring anxiety disorders including specific phobias and substance use disorders. The integrated treatment approach addresses both conditions in parallel, with attention to the medications that may have been used for phobia management and the development of behavioural skills that support both anxiety management and substance use recovery. The residential setting allows the intensive work needed for patients with complex co-occurring presentations.

When to seek professional treatment

Not everyone with discomfort about enclosed spaces needs formal treatment. Mild claustrophobia that does not significantly limit life activities and that the person can manage with simple strategies (taking stairs, avoiding particularly distressing situations, using basic anxiety management techniques) may not require professional intervention. The threshold for treatment is the impact on daily life and the suffering caused by the condition. When the avoidance produces meaningful limitations or when the anxiety produces significant distress, professional treatment is appropriate.

Specific situations that warrant professional treatment include avoidance of medical care because of fear of MRI or CT scanners, inability to use elevators in situations where stairs are not practical, avoidance of air travel that limits professional or personal opportunities, severe panic that occurs in routine situations and prevents normal function, and use of alcohol or other substances to manage anxiety in enclosed spaces. The pattern of using substances to manage phobic anxiety is itself an indication for treatment regardless of the severity of the phobia.

Finding a therapist trained in evidence-based treatment for specific phobias is the practical first step. Psychologists and licensed therapists with cognitive behavioural therapy training are typically the most appropriate providers. The Anxiety and Depression Association of America (ADAA) provides a therapist locator that can identify CBT-trained providers in specific areas. Psychiatrists can provide medications when those are appropriate, often in coordination with the behavioural therapist. The treatment is well-defined and the outcomes are good, so finding the right provider is the main practical step.

Most people with claustrophobia do not seek treatment because they have organised their lives to avoid the feared situations and may not recognise that their avoidance constitutes significant impairment. The recognition that a specific phobia is a treatable condition, that effective treatment is available, and that the treatment is brief and does not require ongoing medication, often motivates people to seek treatment when they had not previously considered it. Family members who recognise the avoidance pattern can play a useful role in encouraging treatment.

Special situations: MRI scans and other unavoidable enclosed spaces

MRI scans are one of the most common situations in which claustrophobia produces specific clinical problems. The cylindrical bore of the scanner, the duration of the scan (typically 30 to 60 minutes), the noise of the machine, and the immobility required all contribute to a particularly demanding exposure. Approximately 1 to 2 percent of MRI scans are aborted because of claustrophobia, and many more produce significant distress that affects the quality of the imaging. Strategies for managing MRI claustrophobia include open MRI scanners (which have a more open design but are not available everywhere and may produce somewhat lower quality images), pre-scan medication with short-acting benzodiazepines or other anxiolytics, distraction techniques during the scan including music, calming visualisations, and specific scan techniques that minimise the time in the bore.

Air travel is a second common situation where claustrophobia interferes with important life activities. The combination of being enclosed in the cabin, the inability to escape, the duration of flights, and the additional flying-related anxieties that many people have produces significant distress for some travellers. Treatment for fear of flying often combines claustrophobia treatment with specific work on other flying-related concerns. Several airline-sponsored programs and online courses provide structured treatment for fear of flying that includes the claustrophobic element.

Medical procedures including dental work, colonoscopy, and other procedures that involve being still in confined positions can be challenging for claustrophobic patients. Pre-procedure conversations with the medical team about claustrophobia, planning for breaks if needed, and pre-procedure anxiolytic medication where appropriate can substantially improve the experience. Many patients with claustrophobia avoid recommended medical care because of the phobia, with the consequence of delayed diagnosis and treatment of medical conditions. The phobia treatment is partly important for the health implications beyond the immediate distress.

When alcohol use disorder is part of the picture

Alcohol use disorder, the clinical term for what most people call alcoholism, frequently coexists with anxiety disorders including specific phobias. The pattern of drinking to manage specific situations (flights, social events that involve enclosed spaces, medical appointments requiring procedures) can develop into more general patterns of evening drinking, weekend drinking, and eventually heavy drinking that meets criteria for alcohol use disorder. Many people with this pattern do not see themselves as having an alcohol problem because they associate their drinking with their phobia management rather than recognising it as a substance use issue.

Treatment of co-occurring alcohol use disorder and specific phobia requires integrated care. Medical detoxification under supervision may be needed for severe alcohol use. The phobia treatment proceeds in parallel, with attention to the fact that the phobia treatment may be more difficult during early sobriety because the patient cannot use alcohol as the safety behaviour they have been relying on. The combination produces better long-term outcomes than treating either condition alone, with attention to the specific situations that previously triggered both the phobia and the drinking. Phuket Island Rehab provides residential addiction medicine treatment for international patients with co-occurring alcohol use disorder and anxiety disorders including specific phobias.

Summary

Claustrophobia is the fear of enclosed or confined spaces, classified in the DSM-5 as a specific phobia of the situational type. The condition affects 4 to 7 percent of people at some point in life and produces significant distress and avoidance behaviour. The symptoms during exposure include the classic features of panic including rapid heart rate, sweating, breathing difficulty, chest tightness, fear of suffocating, and the urge to escape. The causes involve conditioning through experience, observational learning, genetic vulnerability, and evolutionarily prepared fear responses. Treatment with exposure therapy is highly effective, with approximately 80 percent of patients achieving significant improvement in 8 to 12 sessions. Cognitive behavioural therapy addresses the catastrophic thoughts that maintain the fear. Medications support but do not replace behavioural treatment, with SSRIs for chronic anxiety and short-term benzodiazepines for occasional unavoidable situations being the main options. The relationship between untreated phobias and substance use disorders is meaningful, with many people using alcohol or benzodiazepines to manage feared situations and developing dependence over time. Integrated treatment of co-occurring phobia and substance use produces better outcomes than treating either alone. As Dr. Ponlawat Pitsuwan summarises, “Specific phobias including claustrophobia are among the most treatable conditions in mental health, with brief structured treatment producing durable resolution in the majority of patients. The barrier is usually not the difficulty of treatment but the recognition that the avoidance pattern represents a treatable condition rather than a permanent feature of life.”

Frequently asked questions

What is claustrophobia?

Claustrophobia is the fear of enclosed or confined spaces. The condition is classified in the DSM-5 as a specific phobia of the situational type. Common triggers include elevators, MRI scanners, small rooms, crowded transportation, tunnels, and other confined environments. The fear is recognised by the person as excessive but cannot be controlled by reasoning, and exposure produces intense anxiety, physical symptoms, and the urge to escape immediately.

What causes claustrophobia?

The causes include classical conditioning through traumatic experiences in enclosed spaces, observational learning from watching others react with fear, family history suggesting genetic vulnerability, biological factors including amygdala reactivity, and evolutionarily prepared fear responses that make humans particularly susceptible to learning fears of enclosed spaces. Most cases involve multiple contributing factors rather than a single cause.

How is claustrophobia treated?

The gold-standard treatment is exposure therapy, in which the person gradually approaches feared situations under structured guidance until the fear response extinguishes. Cognitive behavioural therapy addresses the catastrophic thoughts that maintain the fear. The treatment typically involves 8 to 12 sessions over 2 to 3 months and produces significant improvement in approximately 80 percent of patients. Medications including SSRIs and short-term benzodiazepines can support treatment but are not the primary intervention.

Can claustrophobia be cured?

Yes. Claustrophobia is highly treatable with exposure therapy and cognitive behavioural therapy. Approximately 80 percent of patients achieve significant improvement and approximately 50 percent achieve full resolution of the phobia. Treatment effects are durable, with most patients maintaining their gains for years after treatment ends. The brief and effective nature of the treatment makes claustrophobia one of the more rewarding conditions to treat in mental health practice.

What can I do during an MRI scan if I have claustrophobia?

Strategies include discussing claustrophobia with the imaging team beforehand and arranging for breaks if needed, pre-medication with a short-acting benzodiazepine such as alprazolam 30 to 60 minutes before the scan, use of an open MRI scanner if available, distraction techniques during the scan including music and calming visualisations, and longer-term exposure therapy if the procedure is one that may need to be repeated. Many MRI facilities are familiar with claustrophobia and can accommodate patients with appropriate preparation.

Is claustrophobia an anxiety disorder?

Yes. Claustrophobia is classified as a specific phobia, which is a category of anxiety disorder in the DSM-5. Specific phobias differ from generalised anxiety disorder and panic disorder in that the anxiety is bound to specific situations or objects (in this case enclosed spaces) rather than being free-floating or occurring spontaneously. The treatment principles are similar to those for other anxiety disorders, with exposure-based therapy being particularly important for specific phobias.

Sources

• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Publishing; 2013.
• National Institute of Mental Health (NIMH). Specific Phobias. https://www.nimh.nih.gov/health/statistics/specific-phobia
• Choy Y, Fyer AJ, Lipsitz JD. Treatment of specific phobia in adults. Clinical Psychology Review. 2007;27(3):266-286. https://www.sciencedirect.com/science/article/abs/pii/S0272735806001097
• Wolitzky-Taylor KB, Horowitz JD, Powers MB, Telch MJ. Psychological approaches in the treatment of specific phobias: a meta-analysis. Clinical Psychology Review. 2008;28(6):1021-1037.
• Anxiety and Depression Association of America (ADAA). Find a Therapist. https://www.adaa.org/finding-help/treatment
• Foa EB, Hembree EA, Rothbaum BO. Prolonged Exposure Therapy for PTSD: Therapist Guide. Oxford University Press; 2007.
• Substance Abuse and Mental Health Services Administration (SAMHSA). National Helpline. https://www.samhsa.gov/find-help/national-helpline

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