From the American series “Treatments That Work”, here I review Mastering Your Fears and Phobias. Specific phobias are incredibly common and affect a significant proportion of the population, some of whom are severe enough to seek treatment. Mastering Your Fears and Phobias is therefore potentially a very beneficial resource, both for clinicians and those suffering as a consequence of a particular fear or phobia. These books cover a wide spectrum of fears and phobias, and are grouped in a way that reflects the heterogeneity among specific phobias. Namely, blood, needles, doctors and dentists are followed by claustrophobia, animals and insects, heights, driving and flying, and finally storms, water, choking and vomiting. Both the Therapist Guide and the accompanying Client Workbook are user-friendly in terms of layout and comprehensibility of content. Time is taken to introduce the evidence-base for the efficacy of cognitive behaviour techniques in the treatment of fears and phobias; this supplies the therapist with knowledge and confidence in this form of treatment.

The Therapist Guide is divided into easy to digest sections and leads the reader through what the authors suggest are the essential stages, before, during, and after treatment of fears and phobias. The empirical support for exposure therapy particularly when combined with cognitive restructuring is well-explained, thus equipping the reader with a clear underlying model in which to feel confidence. This is followed by a description of the phenomenology of fears and phobias, theories regarding the development of fears and phobias and ways to develop an effective treatment plan. As a result, the therapist can feel well-prepared prior to embarking on delivering the treatment itself. The Therapist Guide introduces many useful clinical materials throughout, including the Phobic Objects and Situations form. Blank copies of all materials are provided in the Workbook. These materials help the client, with aid from the therapist, to tackle the several cognitive and behavioural treatment components involved in fears and phobias, for example identifying their avoidance and coping strategies.

Once the treatment principles and procedures are explained, chapters tailored to each of the aforementioned fears and phobias follow. Each chapter includes detailed case examples and directs the therapist to the corresponding Workbook chapter. The therapist is reminded when to introduce treatment concepts as well as what homework to give and at what time point to set it. Clinical vignettes punctuate this guide, some of which provide suggestions on how best to manage potential stumbling blocks in therapy.

The coupled Client Workbook is an easy to use and thorough accompaniment to the Therapist Guide. Its strengths include the length of time taken to ensure clients understand the treatment's rationale and the way clients are encouraged to work independently through the several homework tasks set. Clients are expected to read the chapter (or chapters) that correspond to their fear or phobia. Within each chapter, a definition is followed by a case example and treatment strategies, introduced with the aid of materials and concepts that by this stage should be familiar to the client. A selection of recommended films to watch and websites with footage, for example of storms, are provided in the workbook. These materials for exposure tasks are a great resource and save the therapist spending hours trawling the internet for ideas. Intervention comes in the form of a series of steps, designed to make change feel achievable and less daunting. Each chapter ends with a “troubleshooting” question and answer section discussing common difficulties clients may face during exposure. Clients would benefit from reading through these in order to put their minds at ease and normalize their anxieties.

Strengths of Mastering Your Fears and Phobias include its accessibility and problem-focused approach. A collaborative relationship between therapist and client is also very much encouraged. However, I do feel that clients would need high levels of motivation to profit fully from the Workbook. The treatment protocol also appears rigid in terms of its framework, whereas therapists require a degree of flexibility. Clients with fears and phobias can be complex and the inherent heterogeneity requires some treatment flexibility.

Mastering Your Fears and Phobias is by no means a quick-fix guide. Therapist and client are made aware of the investment of time and effort required for the maximum benefits to be gained, including the importance of continued exposure once treatment is completed. I imagine the book would prove most valuable to clinicians with little or no experience in this area of anxiety disorders and best suits use during weekly rather than an intensive treatment format.