An Internet-based Treatment for Flying Phobia
Condition: Flying Phobia
MeSH terms: Phobic Disorders
Study type: Interventional

Summary: 
      Flying phobia (FP) is one of the most prevalent phobias in our society. However, not all
      patients benefit from in vivo exposure, given that an important amount of them do not accept
      the intervention, drop out when they are informed about the intervention procedure, or have
      problems accessing these therapies.

      The aim of the present study is to conduct a feasibility pilot with NO-FEAR Airlines ICBT
      (Campos et al., 2016) using two types of images in the exposure scenarios (still images vs
      360º navigable images). A secondary aim is to explore the potential effectiveness of the two
      active treatment arms compared to a waiting list control group. Finally, we will explore the
      role of navigable images compared to the still images in the level of anxiety, sense of
      presence, and reality judgment in the exposure scenarios and whether the aforementioned
      variables mediate in treatment efficacy.

      Regarding the main aim of this study, we hypothesize that both treatment conditions will be
      well accepted by the participants, but participants will prefer 360º images over still
      images.
    

Detailed description: 
      Flying phobia (FP) is one of the most prevalent phobias in our society. Around 25% of the
      population that flies experiences intense distress during the flight; around 10% of the
      general population does not fly due to intense fear and 20% of people depend on alcohol or
      tranquilizers to overcome the fear of flying.

      In vivo exposure is the most effective psychological treatment for specific phobias. However,
      not all patients benefit from in vivo exposure, given that an important amount of them do not
      accept the intervention, drop out when they are informed about the intervention procedure, or
      they have problems to access these therapies.

      Information and Communication Technologies (ICTs) can improve treatment adherence and
      acceptance. Particularly, computerized programs offer remarkable advantages such as a
      reduction in direct therapeutic contact time, the possibility of standardizing treatment as
      much as possible with a steep exposure gradient, the low cost and, maybe most importantly,
      access to patients who would not be very willing to subject themselves to in vivo exposure.
      The application of cognitive-behavioural procedures such as exposure through interactive
      computer programs is especially recommended.

      On the other hand, it is important to explore the role of the degree of immersion and sense
      of presence in the psychological treatments with iCBTs due to the contradictory conclusions
      that had been found in the literature. Therefore, it is expected that the present work
      advances in the knowledge in this field exploring these factors in an Internet-based
      self-applied treatment program for FP evaluating if a change in the exposure images used in
      the program NO-FEAR Airlines (Campos et al., 2016) will be feasible in a future RCT.
    

Intervention name(s): NO-FEAR Airlines
Intervention type(s): Behavioral
Intervention description(s): "NO-FEAR Airlines" is an Internet-based self-applied treatment program that allows people with Flying Phobia the exposure to images and sounds related to their phobic fears on a standard personal computer. The treatment can be totally self-applied.
"NO-FEAR Airlines" contains 6 scenarios related to the flight process: (1) flight preparation, (2) airport, (3) boarding and taking off, (4) the central part of the flight, (5) the airplane's descent, approach to the runway, and landing, (6) sequences with images and auditory stimuli related to plane crashes.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Specific Phobia; Computer-Assisted Exposure; Self-help; Internet-based Therapy; Sense of presence