How to overcome a fear of dogs: Evidence-based therapy for cynophobia
What is cynophobia?
The disproportionate fear of a particular object or situation, which causes clinically significant distress or impairment in functioning, is called a specific phobia. Specific phobia is one of the most common types of psychological disorders, affecting 1 in 8 individuals in their lifetime.1
A phobia of dogs is one of the most common animal phobias, along with fear of snakes and spiders. However, unlike spiders and snakes which can usually be easily avoided, dogs can be found in almost any public space, making a fear of dogs particularly distressing and debilitating for sufferers.
Fortunately, there is a highly effective, and relatively short-term, psychological therapy that works for the vast majority of children and adults suffering from a specific phobia.
How is it treated?
The 'gold standard' psychological treatment for animal phobias, like cynophobia, is a type of behaviour therapy known as exposure therapy.
In exposure therapy, the individual is assisted by an experienced clinician to approach the object or situation that they fear while being coached on how to deal with their anxiety.
This can be done very gradually, over a number of sessions, or in a single prolonged session, depending on the individual’s readiness to progress.
Importantly, the individual is never pushed into situations they are unwilling to encounter, and the clinician seeks their consent at every stage. This process should be positive, empowering and even fun - it would be completely counter-productive if it was a highly stressful or terrifying experience.
Over the course of exposure therapy for cynophobia, these new positive learning experiences help to 're-calibrate' the individual's fear response, so that it is no longer triggered by the presence of a dog.
How effective is exposure therapy?
Exposure therapy for phobias is extremely effective - perhaps more so than any other psychological therapy for any other mental health condition.
It is the only treatment for specific phobias endorsed by the American Pyschological Association and rated by the Australian Psychological Society as having the highest level of empirical support.
Exposure therapy has been developed and studied over many decades, and there are numerous scientific studies demonstrating its effectiveness compared to other treatments.
A ‘meta-analysis’ (an analysis of previous studies) of 33 clinical trials conducted over three decades, concluded that exposure therapy was the most effective treatment for phobias. Furthermore, in vivo exposure therapy (i.e. exposure in real life as opposed to virtual reality, for example), was found to be the most effective type of exposure therapy.2
In fact, exposure therapy is so effective, one study reported a significant reduction of symptoms in over 90% of participants, which was still maintained at follow-up several years after treatment.3
This is all fantastic news for sufferers of cynophobia, as such high rates of success are virtually unheard of for treatments of other mental health conditions.
What about other treatments?
Although exposure therapy is by far the most well-researched and scientifically-supported treatment approach for phobias, there are a number of other approaches that are sometimes touted as alternative treatment options.
These alternatives include: hypnotherapy; neuro-linguistic programming (NLP); emotional freedom technique (EFT); cognitive therapy; and anxiety-reducing medications.
Hypnotherapy, NLP and EFT are treatment modalities which are not grounded in science or considered to be evidence-based. Nonetheless, it could be argued that what really matters is how well a treatment works, rather than how theoretically sound it is.
Unfortunately, however, there are very few high-quality scientific studies examining these approaches, and those that do exist consistently fail to demonstrate their effectiveness in the treatment of phobias.4,5
A scientific review of cognitive therapy (a treatment approach which aims to change unhelpful thoughts) concluded that "the literature does not support the utilization of cognitive treatments" for phobias.6 Other studies have found that adding cognitive procedures to exposure therapy provides no additional benefit.2
Finally, a scientific review of the use of medication in specific phobias concluded that the research "does not support their use as the primary treatment modality" but that "exposure-based treatments are considered to be the gold standard treatment for specific phobias".7
1. Kessler, R. C., Berglund, P. A., Demler, O., Jin, R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6), 593-602.
2. Wolitzky-Taylor, K. B., Horowitz, J. D., Powers, M. B., & Telch, M. J. (2008). Psychological approaches in the treatment of specific phobias: A meta-analysis. Clinical Psychology Review, 28(6), 1021-1037.
3. Öst, L. G. (1989). One-session treatment for specific phobias. Behaviour Research and Therapy, 27(1), 1-7.
4. Pelissolo, A. (2016). Hypnosis for anxiety and phobic disorders: A review of clinical studies. Presse Medicale, 45(3), 284-290.
5. Sturt, J., Ali, S., Robertson, W., Metcalfe, D., Grove, A., Bourne, C., & Bridle, C. (2012). Neurolinguistic programming: a systematic review of the effects on health outcomes. British Journal of General Practice, 62(604), 757-764.
6. Last, C. G. (1984). Cognitive treatment of phobia. Progress in Behaviour Modification, 16, 65-82.
7. Ameringen, M., Mancini, C., & Patterson, B. (2008). Pharmacotherapy for Social Anxiety Disorder and Specific Phobia. In (Ed.), Oxford Handbook of Anxiety and Related Disorders. Oxford University Press.