Abstract
A large-group one session treatment (LG-OST) combining exposure and diaphragmatic breathing as a bodily coping element was carried out to investigate its feasibility and effectiveness in a sample of 43 highly dental fearful individuals treated simultaneously. We assessed subjective dental fear, dysfunctional dental-related beliefs, and perceived control pre- and post-intervention and at four-month follow-up. Participants additionally performed a behavioural approach test (BAT) pre- and post-intervention. During the applied exposure exercises, four participants (9.3%) discontinued the program all reporting too high levels of distress. Regarding subjective dental fear and dysfunctional dental related beliefs post treatment effects, LG-OST showed medium to large effect sizes, ranging from Cohen’s d = 0.51 to d = 0.84 in the Intention-to-Treat analysis. Subjective dental fear improved clinically significantly in about one fourth (25.6%) of therapy completers. All post-treatment effects remained stable over time. Concerning the behavioral fear dimension, we observed a strong ceiling effect. Already at pre-assessment, participants accomplished more than six out of seven BAT-steps. Thus, behavioral approach did not increase significantly following treatment. Overall, the LG-OST protocol proved feasible and efficient. Compared to other one-session individual and multi-session group treatments the observed LG-OST effects were smaller. However, if LG-OST could match the efficacy of highly intensive short treatments delivered in an individual setting in the future, for example, by applying a wider array of exposure exercises, it could be a very useful treatment option as an intermediate step within a stepped care approach.
Highlights
Specific Phobias (SP) are proven to be of high health-economic relevance, they are widely considered to be less restrictive than other mental disorders
The current study focused on the evaluation of feasibility of large-group one session treatment (LG-one-session treatments (OST)) in a sample of highly dental-fearful individuals
Individuals who came to the dental clinic between August 2014 and January 2015, exhibited a heightened fear score in the Hierarchischer Angstfragebogen’ (HAF) (>35) and reported that they had avoided dental surgeries due to dental-fear for more than two years were informed about LG-OST and encouraged by the dentists to register for the LG-OST-program online
Summary
Specific Phobias (SP) are proven to be of high health-economic relevance, they are widely considered to be less restrictive than other mental disorders. SPs are the most common anxiety disorder and following major depression, they are the second most prevalent of all psychiatric disorders (Wittchen et al, 2011). Dental Phobia (DP) is among the most critical SPs in terms of both prevalence and impairment (Oosterink et al, 2009). The risk of somatic comorbidities, such as cardiac disease (Cronin, 2009) resulting from poor dental health, as well as psychiatric comorbidities such as other anxieties, mood disorders or substance abuse (Roy-Byrne et al, 1994) is greatly enhanced in individuals suffering from DP
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