(PS8-97) Methodological Enhancements for Increasing Efficacy of Teletherapy One Session In-Vivo Exposure for Arachnophobia

Decades of research support one-session treatment (OST) as an effective intervention for specific phobias, including arachnophobia. Recent studies (Stech et al., 2021; Cherestal et al., 2021; Peros et al., 2021; Feusner et al., 2022) have demonstrated that various forms of exposure therapy, including virtual reality exposure therapy and exposure and response prevention, can be successfully adapted to teletherapy. These studies show significant symptom reduction and comparable outcomes between teletherapy and in-office exposure therapy treatments. In addition to favorable outcome data, the briefer intervention model reduces many barriers associated with traditional multi-session protocols. Compared to these lengthier treatments, which are more time-consuming, disruptive to daily life, and costly, single-session treatments are more accessible and feasible for patients.  

This study aims to build upon existing literature and explore methodological enhancements for OST delivered through teletherapy by investigating and comparing three protocols for treating arachnophobia through an OST model: (1) imaginal exposure prior to in-vivo exposure, (2) mindfulness-based exercise prior to in-vivo exposure, and (3) psychoeducation prior to in-vivo exposure. In the imaginal exposure group, participants will engage in a 15-minute imaginal exposure facilitated by the therapist. Those in the mindfulness group will complete a 15-minute mindfulness activity. Participants assigned to the psychoeducation group will watch a 15-minute pre-recorded educational video about spiders and their ecological roles. All groups complete a graduated in-vivo exposure immediately following their respective pre-treatments. All protocols are identical, differing only in the treatment modifier that precedes the in-vivo exposure. Maximum treatment duration is three hours.  

Thirty adult participants will be recruited through Hofstra University's Phobia and Trauma Clinic and online advertisements. Perspective participants will complete an online behavioral avoidance test to determine if they met inclusion criteria. Participants who meet inclusion criteria will be contacted by the primary researcher to schedule a three-hour OST that will take place at Hofstra University Psychological Evaluation Research and Counseling Center. On the day of their session, participants will be brought to a pre-set treatment room where they will interact via Zoom with a therapist. The participant will be the only person physically in the room to simulate the aloneness of a home environment. The therapist will lead the participant through the OST via teletherapy. The therapist, with their own spider, will model interactions as the patient progresses through a hierarchy to approach and engage with the spider. At the conclusion of treatment, the participant will complete two self-report measures and a video behavioral avoidance test. The primary outcomes include self-reported spider fear as measured by the Spider Phobia Questionnaire and Fear of Spiders Questionnaire, as well as behavioral avoidance assessed via a virtual Behavioral Avoidance Test. Data will be collected at three time points: pre-treatment, post-treatment, and three weeks after treatment.